Abstract
To evaluate whether pregnancies conceived via assisted reproductive technology and exposed to Hurricane Katrina (HK), one of the most destructive natural disasters in United States history, were more prone to adverse perinatal outcomes, miscarriages, or sex disparities compared with pregnancies established but not directly exposed to the natural disaster. Retrospective cohort study. Women 18 years and older undergoing fresh ART cycles that resulted in singleton pregnancies and entered in the SART CORS database from 2004 to 2008. Incidence of full-term and preterm delivery, miscarriage rate, infant weight at birth, and infant sex ratio. Total follicle stimulating hormone (FSH) stimulation dosage and number of oocytes retrieved. Between January 2004 and December 2008, a total of 451,848 fresh autologous IVF cycles were recorded in SART CORS, leading to 190,624 pregnancies and 129,499 live births. After controlling for potential confounders, our results demonstrate no association between HK exposure and overall preterm deliveries (< 37 weeks) in women with singleton pregnancies conceived after ART. Other perinatal outcomes such as rate of spontaneous abortion or infant weight at birth in the exposed and unexposed groups were also not associated with HK. A comparison of pre and post disaster sex ratios revealed fewer males were born after HK (51.0% vs. 49.4%), showing a trend of decreased male infant births that was least in part associated with HK (CI 0.81–1.01; p = 0.07). Exposure to HK did not appear to affect perinatal outcomes such as the rate of preterm delivery or the rate of spontaneous abortion. Extreme stress may be a factor that contributes to a reduced male to female secondary sex ratio.
Highlights
Natural disasters such as hurricanes and earthquakes have been increasing in incidence over the past decade, with 90% of these being droughts, storms, and floods
We aimed to investigate if pregnancies conceived via assisted reproductive technology (ART) in the post-Hurricane Katrina (HK) period were more prone to adverse perinatal outcomes, miscarriage, or sex ratio disparities compared with those ART pregnancies established 18 months prior to HK
Between January 2004 and December 2008, a total of 451,848 fresh autologous in-vitro fertilization (IVF) cycles were recorded in SART CORS, leading to 190,624 pregnancies and 129,499 live births
Summary
Natural disasters such as hurricanes and earthquakes have been increasing in incidence over the past decade, with 90% of these being droughts, storms, and floods These events have been expected to increase in frequency as global climates change and as a result, the number of people exposed to such disasters will increase over time[1]. One prospective cohort study exploring exposure to HK reported an increased frequency of low birth weight (< 2500 g) and preterm delivery (< 37 weeks) in women who were early in pregnancy or conceived within 6 months after HK12 Other perinatal outcomes such as spontaneous abortions (SA) have been reported to increase following natural disasters. The national Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) database was used to identify women who underwent ART cycles during the time period immediately spanning HK in both affected and unaffected states
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