Dataset Information

Adequate prenatal care reduces the risk of adverse pregnancy outcomes in women with history of infertility: a nationwide population-based study.

ABSTRACT:

Objectives

To investigate the effects of various measures of prenatal care on adverse pregnancy outcomes in women with a history of infertility.

Study design

A retrospective cohort study.

Methods

Data were derived by linking 2 large nationwide population-based datasets, the National Health Insurance Research Database and Taiwan Birth Certificate Registry. The study sample included 15,056 women with an infertility diagnosis and 60,224 randomly selected women without infertility matched to the study sample by maternal age. A conditional logistic regression analysis was performed for the analysis.

Results

Women diagnosed with infertility respectively had 1.39 (95% CI, 1.06~1.83), 1.15 (95% CI, 1.08~1.24), 1.13 (95% CI, 1.08~1.18), and 1.08 (95% CI, 1.05~1.12) higher odds of having very low birth weight (VLBW) babies, preterm births, labor complications, and cesarean sections (CSs) compared to women without infertility. Inadequate numbers of total and major prenatal visits and late initiation of prenatal care increased the risks of adverse pregnancy outcomes in women with infertility, especially the risk of a VLBW baby. However, no significant associations were found for the risks of adverse birth outcomes in infertile women with adequate prenatal care compared to fertile women with adequate care.

Conclusions

Study findings suggest that adequate prenatal care can reduce the risk of adverse pregnancy outcomes in women with infertility.

SUBMITTER: Alibekova R

PROVIDER: S-EPMC3866182 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

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Publications

Adequate prenatal care reduces the risk of adverse pregnancy outcomes in women with history of infertility: a nationwide population-based study.

Alibekova Raushan R Huang Jian-Pei JP Chen Yi-Hua YH

PloS one 20131217 12

<h4>Objectives</h4>To investigate the effects of various measures of prenatal care on adverse pregnancy outcomes in women with a history of infertility.<h4>Study design</h4>A retrospective cohort study.<h4>Methods</h4>Data were derived by linking 2 large nationwide population-based datasets, the National Health Insurance Research Database and Taiwan Birth Certificate Registry. The study sample included 15,056 women with an infertility diagnosis and 60,224 randomly selected women without infertil ...[more]

PMID: 24358347

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Project description:BackgroundInfertility has been associated with the risk of adverse pregnancy outcomes. It is not clear whether infertility and underlying causes of infertility or the use of medically assisted reproduction (MAR) therapies are responsible for the observed associations. In this study, we aimed to evaluate the association of history of infertility with pregnancy outcomes and identify whether the associations, if present, differed by subgroups defined by the use of MAR.MethodsProspective study of 2201 pregnant women from the Boston-area Project Viva cohort. The exposure was history of infertility based on self-reported time to pregnancy ≥12 mo (or ≥ 6 mo if ≥35 y) or use of MAR; a diagnosis of infertility or claims for infertility treatments from medical records. The outcomes included: gestational glucose tolerance (gestational diabetes, impaired glucose tolerance, isolated hyperglycemia vs. normoglycemia), hypertensive disorders (gestational hypertension/preeclampsia vs. normotension), gestational weight gain (inadequate/excessive vs. adequate), systolic (SBP) and diastolic blood pressure, birthweight-for-gestational age z-score (tertile 2 and 3 vs. 1), preterm birth (<37 vs. ≥37 weeks at delivery), and birth outcome (pregnancy loss vs. live birth). We performed linear and logistic/multinomial regression analyses adjusted for age, race/ethnicity, age at menarche, pre-pregnancy BMI, and prenatal smoking.ResultsMean (SD) age was 32.0 (5.0) years, and 18.8% of women had history of infertility, 32.6% of whom used MAR. SBP across pregnancy was 0.72 mmHg higher in women with vs. without infertility (95% CI 0.02, 1.42). The associations were stronger among women who used MAR (β 1.32 mmHg, 95% CI 0.21, 2.44), especially among those who used gonadotropins or gonadotropin-releasing hormone [GnRH] agonists (β 1.91 mmHg, 95% CI 0.48, 3.35). Other outcomes were not associated with history of infertility.ConclusionsA history of infertility was associated with higher SBP during pregnancy, with stronger associations among those who used gonadotropins or GnRH agonists. Future studies are needed to confirm these findings and determine their clinical implications.

Project description:BACKGROUND:Pesticide exposure during pregnancy is thought to adversely affect fetal growth, which in turn may impact child growth, but results have been inconsistent across studies and few have explored these effects in developing countries. OBJECTIVES:To quantify urinary concentrations of pesticide biomarkers in early pregnancy (<16?weeks' gestation), and to estimate the association of these concentrations with preterm birth, low birth weight, small for gestational age, and stunting at ~1 and 2?years of age. METHODS:Eight pesticide biomarkers were quantified in urine collected from 289 pregnant women (aged 18-40?years) participating in a birth cohort study in Bangladesh. Anthropometry measurements were conducted on the index child at birth and approximately 1 and 2?years of age. A directed acyclic graph was used to identify minimal sufficient adjustment sets. Log-binomial regression was used to estimate the relative risk (RR) with 95% confidence intervals (CI). RESULTS:3,5,6-trichloro-2-pyridinol (TCPY), a metabolite of chlorpyrifos and chlorpyrifos methyl, and 4-nitrophenol, a metabolite of parathion and methyl parathion, were detected in nearly all women with geometric mean (95% CI) values of 3.17 (2.82-3.56) and 18.66 (17.03-20.46) µg/g creatinine, respectively. 3-phenoxybenzoic acid (3-PBA), a non-specific metabolite of several pyrethroids, and 2-isopropyl-4-methyl-6-hydroxypyrimidine (IMPY), a diazinon metabolite, were detected in 19.8% and 16.1% of women, respectively. The remaining four pesticide biomarkers were detected in <10% of women. Women in the highest quartile of 4-nitrophenol were more than 3 times more likely to deliver preterm than women in the lowest quartile: unadjusted RR (95% CI), 3.57 (1.65, 7.73). Women in the highest quartile of 4-nitrophenol were also at increased risk of having a child born small for gestational age: RR (95% CI) adjusted for household income, maternal education, and maternal total energy and meat intake, 3.81 (1.10, 13.21). Women with detectable concentrations of IMPY were at increased risk of having a child born with low birth weight compared to women with non-detectable concentrations: adjusted RR (95% CI), 2.13 (1.12, 4.08). We observed no association between any of the pesticide biomarkers and stunting at 1 or 2?years of age. DISCUSSION:Exposure to the insecticides parathion and diazinon during early pregnancy may increase the risk of adverse birth outcomes.

Dataset Information

Adequate prenatal care reduces the risk of adverse pregnancy outcomes in women with history of infertility: a nationwide population-based study.

Objectives

Study design

Methods

Results

Conclusions

Publications

Adequate prenatal care reduces the risk of adverse pregnancy outcomes in women with history of infertility: a nationwide population-based study.

Similar Datasets

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