| Title: |
Maternal Morbidity and Medically Assisted Reproduction Treatment Types |
| Authors: |
Pelikh, Alina; Smith, Ken R.; Myrskylä, Mikko; Debbink, Michelle P.; Goisis, Alice |
| Contributors: |
Helsinki Institute for Demography and Population Health |
| Publisher Information: |
Lippincott Williams and Wilkins |
| Publication Year: |
2025 |
| Collection: |
Helsingfors Universitet: HELDA – Helsingin yliopiston digitaalinen arkisto |
| Subject Terms: |
Gynaecology and paediatrics; Infertility treatment; Birth certificate; United-states; Technology; Outcomes; Validity; Health; Impact; Risk |
| Description: |
OBJECTIVE: To compare odds of maternal morbidity by mode of becoming pregnant and type of medically assisted reproduction treatments: fertility-enhancing drugs, intrauterine insemination (IUI), and assisted reproductive technology (ART) with autologous or donor oocytes. METHODS: Birth certificates were used to study maternal morbidity among the birthing population in Utah between 2009 and 2017 (N=469,919 deliveries); 22,543 pregnancies occurred through medically assisted reproduction (4.8%). Maternal morbidity was identified as a binary variable, indicating the presence of any of the following: blood transfusion, unplanned operating room procedure, admission to intensive care unit, eclampsia, unplanned hysterectomy, and ruptured uterus. Using logistic regression, we assessed maternal morbidity among medically assisted reproduction pregnancies (overall and by type of treatment) compared with unassisted pregnancies in the overall sample before and after adjustment for individual sociodemographics (age at birth, family structure, level of education, Hispanic origin, parity), and pre-existing comorbidities (ie, chronic hypertension, heart disease, asthma), multifetal gestation, and obstetric comorbidities (ie, placenta previa, placental abruption, cesarean delivery). RESULTS: Individuals becoming pregnant through medically assisted reproduction had higher risk of maternal morbidity, with odds ratios (ORs) increasing as medically assisted reproduction treatments become more invasive. Associations were largely attenuated when accounting for multifetal gestation and further reduced after controlling for obstetric comorbidities. However, ART with autologous oocytes (OR 1.46, 95% CI, 1.20–1.78) maintained higher coefficients compared with unassisted pregnancies. In models including only singletons, after controlling for obstetric comorbidities, the OR differences in maternal morbidity between all medically assisted reproduction groups and unassisted pregnancies were no longer statistically significant. CONCLUSION: More ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
This work was supported by European Research Council agreement n. 803958(to A.G.). M.M. was supported by the Strategic Research Council, FLUX consortium, decision numbers 345130 and 345131; by the National Institute on Aging (R01AG075208); by grants to the Max Planck-University of Helsinki Center from the Max Planck Society (Decision number 5714240218), Jane and Aatos Erkko Foundation, Faculty of Social Sciences at the University of Helsinki,and Cities of Helsinki, Vantaa and Espoo; and the European Union (ERC Synergy, BIOSFER, 101071773). Views and opinions expressed are, however, those of the author, only, and do not necessarily reflect those of the European Union or the European Research Council. Neither the European Union nor the granting authority can be held responsible for them. We thank the Pedigree and Population Resource of Huntsman Cancer Institute, University of Utah (funded in part by the Huntsman Cancer Foundation) for its role in the ongoing collection, maintenance, and support of the Utah Population Database. We also acknowledge partial support for the Utah Population Database through grant P30 CA2014 from the National Cancer Institute, University of Utah, and from the University of Utah's program in Personalized Health and Utah Clinical and Translational Science Institute. M.P.D. receives salary support from the March of Dimes and the American Board of Obstetrics and Gynecology as part of the Reproductive Scientist Development Program, as well as NICHD 1U54HD113169 and NIMHD 1R21MD019175-01A1.; https://hdl.handle.net/10138/600208; 85213833647; 001398999900019 |
| Availability: |
https://hdl.handle.net/10138/600208 |
| Rights: |
cc_by ; info:eu-repo/semantics/openAccess ; openAccess |
| Accession Number: |
edsbas.B1EE12EC |
| Database: |
BASE |