Does ART increase the risk for CD?

  • Stern JE & al.
  • Fertil Steril
  • 1 Aug 2018

  • curated by Elisabeth Aron, MD, MPH, FACOG
  • Clinical Essentials
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • 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.

Key results

  • 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.

Study design

  • 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

Limitations

  • Use of population-based data.
  • It is not clear whether subfertile women are an appropriate comparison/control group for ART-treated women.

Please confirm your acceptance

To gain full access to GPnotebook please confirm:

By submitting here you confirm that you have accepted Terms of Use and Privacy Policy of GPnotebook.

Submit