Pregnancy
Mode of conception and pregnancy outcomes at term among low-risk nulliparous patients
By Cozzi-Glaser GD, Blanchard CT, Pace LA and 4 others.
Abstract
Introduction
Available data suggest that assisted reproductive technology (ART) is associated with adverse perinatal outcomes; however, prior studies have been confounded by multifetal gestations, preterm birth, and patient medical comorbidities. There are limited data on pregnancy outcomes among ART-conceived low-risk singleton pregnancies delivering at term. Thus, we aimed to measure the association between mode of conception and mode of delivery among low-risk nulliparous patients delivering singleton gestations at term.
Methods
Secondary analysis of the ARRIVE trial (NCT01990612), a multicenter randomized, controlled, unmasked, parallel-group trial of nulliparous patients delivering at term, March 2014-August 2017. Pregnancies were categorized by mode of conception as either ART or spontaneous. The primary outcome was cesarean delivery. Secondary outcomes included a composite of perinatal death and severe neonatal complications, and select maternal and neonatal adverse outcomes. Bivariate analyses compared baseline characteristics and outcomes by mode of conception. Primary and secondary outcomes were compared using multivariable logistic regression to generate odds ratios (ORs) and 95% confidence intervals (CIs). Sensitivity analyses by type of ART (in vitro fertilization [IVF] vs. ovulation induction [OI] with or without artificial insemination [AI]) and by embryo age were planned.