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Association between infertility treatment and intrauterine growth: a multilevel analysis in a retrospective cohort study

OBJECTIVES: This study aimed to identify intrauterine growth differences according to infertility treatment compared with spontaneous conception and to describe intrauterine growth trajectories. DESIGN: Retrospective cohort study. SETTING: A single primary and tertiary medical centre in Japan. PARTI...

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Autores principales: Shinohara, Satoshi, Hirata, Shuji, Suzuki, Kohta
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213845/
https://www.ncbi.nlm.nih.gov/pubmed/32350010
http://dx.doi.org/10.1136/bmjopen-2019-033675
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author Shinohara, Satoshi
Hirata, Shuji
Suzuki, Kohta
author_facet Shinohara, Satoshi
Hirata, Shuji
Suzuki, Kohta
author_sort Shinohara, Satoshi
collection PubMed
description OBJECTIVES: This study aimed to identify intrauterine growth differences according to infertility treatment compared with spontaneous conception and to describe intrauterine growth trajectories. DESIGN: Retrospective cohort study. SETTING: A single primary and tertiary medical centre in Japan. PARTICIPANTS: This study included singleton pregnant women with prenatal check-ups and delivery at the University of Yamanashi Hospital between 1 July 2012 and 30 September 2017. Patients were divided into four groups: spontaneous conception, infertility treatment without assisted reproductive technology (ART), fresh-embryo transfer and frozen embryo transfer (FET). INTERVENTIONS: Differences in intrauterine growth according to the infertility treatment, including ART, and birth weight were evaluated. Multilevel analysis was employed to evaluate intrauterine growth trajectories stratified by the sex of the offspring. PRIMARY OUTCOME MEASURE: Estimated fetal weight (EFW) assessed by ultrasound examination. RESULTS: We assessed data from 37 239 prenatal examination results from 2377 pregnant women (spontaneous conception, n=1764; infertility treatment without ART, n=171; fresh-embryo transfer, n=112; and FET, n=330) in the final analysis. Multilevel analysis was adjusted for gestation duration, gestation period, parity, hypertensive disorders of pregnancy, type of infertility treatment, maternal age, smoking status, placenta previa, thyroid disease, gestational diabetes mellitus and the interaction between each potential confounding factor and gestation duration. In male fetuses, the interaction between FET and gestational duration (estimate: 0.36; 95% CI: 0.06 to 0.67) significantly affected the EFW. Similarly, in female fetuses, FET (estimate: −69.85; 95% CI: −112.09 to −27.61) and the interaction between FET and gestation duration (estimate: 0.57; 95% CI: 0.28 to 0.87) significantly affected the EFW. CONCLUSIONS: This study shows that FET affects intrauterine growth trajectory from the second trimester to term, particularly in female fetuses. Our findings require further prospective research to examine the effect of infertility treatment on fetal growth.
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spelling pubmed-72138452020-05-14 Association between infertility treatment and intrauterine growth: a multilevel analysis in a retrospective cohort study Shinohara, Satoshi Hirata, Shuji Suzuki, Kohta BMJ Open Obstetrics and Gynaecology OBJECTIVES: This study aimed to identify intrauterine growth differences according to infertility treatment compared with spontaneous conception and to describe intrauterine growth trajectories. DESIGN: Retrospective cohort study. SETTING: A single primary and tertiary medical centre in Japan. PARTICIPANTS: This study included singleton pregnant women with prenatal check-ups and delivery at the University of Yamanashi Hospital between 1 July 2012 and 30 September 2017. Patients were divided into four groups: spontaneous conception, infertility treatment without assisted reproductive technology (ART), fresh-embryo transfer and frozen embryo transfer (FET). INTERVENTIONS: Differences in intrauterine growth according to the infertility treatment, including ART, and birth weight were evaluated. Multilevel analysis was employed to evaluate intrauterine growth trajectories stratified by the sex of the offspring. PRIMARY OUTCOME MEASURE: Estimated fetal weight (EFW) assessed by ultrasound examination. RESULTS: We assessed data from 37 239 prenatal examination results from 2377 pregnant women (spontaneous conception, n=1764; infertility treatment without ART, n=171; fresh-embryo transfer, n=112; and FET, n=330) in the final analysis. Multilevel analysis was adjusted for gestation duration, gestation period, parity, hypertensive disorders of pregnancy, type of infertility treatment, maternal age, smoking status, placenta previa, thyroid disease, gestational diabetes mellitus and the interaction between each potential confounding factor and gestation duration. In male fetuses, the interaction between FET and gestational duration (estimate: 0.36; 95% CI: 0.06 to 0.67) significantly affected the EFW. Similarly, in female fetuses, FET (estimate: −69.85; 95% CI: −112.09 to −27.61) and the interaction between FET and gestation duration (estimate: 0.57; 95% CI: 0.28 to 0.87) significantly affected the EFW. CONCLUSIONS: This study shows that FET affects intrauterine growth trajectory from the second trimester to term, particularly in female fetuses. Our findings require further prospective research to examine the effect of infertility treatment on fetal growth. BMJ Publishing Group 2020-04-28 /pmc/articles/PMC7213845/ /pubmed/32350010 http://dx.doi.org/10.1136/bmjopen-2019-033675 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Obstetrics and Gynaecology
Shinohara, Satoshi
Hirata, Shuji
Suzuki, Kohta
Association between infertility treatment and intrauterine growth: a multilevel analysis in a retrospective cohort study
title Association between infertility treatment and intrauterine growth: a multilevel analysis in a retrospective cohort study
title_full Association between infertility treatment and intrauterine growth: a multilevel analysis in a retrospective cohort study
title_fullStr Association between infertility treatment and intrauterine growth: a multilevel analysis in a retrospective cohort study
title_full_unstemmed Association between infertility treatment and intrauterine growth: a multilevel analysis in a retrospective cohort study
title_short Association between infertility treatment and intrauterine growth: a multilevel analysis in a retrospective cohort study
title_sort association between infertility treatment and intrauterine growth: a multilevel analysis in a retrospective cohort study
topic Obstetrics and Gynaecology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213845/
https://www.ncbi.nlm.nih.gov/pubmed/32350010
http://dx.doi.org/10.1136/bmjopen-2019-033675
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