- Underlying disease, not assisted reproductive technology (ART) alone, increases risk for cesarean delivery (CD).
Why this matters
- Women with infertility have a higher risk for underlying medical conditions.
- ART-treated women are at increased risk for pregnancy complications.
- ART-treated and subfertile women were more likely to have diabetes, hypertension, or uterine surgery before conception.
- Older age and history of uterine surgery were most common in women with ART.
- ART-treated (aOR, 1.27; 95% CI, 1.19-1.36) and subfertile untreated (aOR, 1.26; 95% CI, 1.07-1.47) women had a similar risk for CD; both had a greater incidence of CD compared with the fertile group.
- Retrospective cohort study using Massachusetts ART data linked to vital records and hospital discharge records.
- Primiparous women with singleton pregnancies who underwent CD between 2004 and 2010 were identified (n=173,130).
- Women were classified as ART (n=5768) if they were linked to ART data, subfertile (n=2657), or fertile (n=164,705).
- Main outcome was mode of delivery.
- Funding: None disclosed
- Use of population-based data.
- It is not clear whether subfertile women are an appropriate comparison/control group for ART-treated women.