Journal List > Perinatology > v.30(2) > 1138600

Baek, Han, Kim, Heo, and Jeon: Perinatal Outcomes of In Vitro Fertilization Versus Natural Pregnancy in Very Low Birth Weight Infants

Abstract

Objective

In vitro fertilization (IVF) pregnancy is increasing. The recent reviews have reported the perinatal outcomes of IVF were preterm birth, low birth weight, small for gestational age, congenital malformations, neurologic disorders and epigenetic defects. We aimed to analyze the perinatal outcomes of IVF compared with natural pregnancy on very low birth weight infants.

Methods

Our study population was derived from Neonatal Intensive Care Unit of the Gangnam CHA Medical Center from 2010 to 2014, consisting of singleton live births in very low birth weight infants. We grouped IVF group (n=24) and control group (natural pregnancy, n=112). We analyzed two groups about maternal characteristics, neonatal characteristics, and outcomes (retinopathy of prematurity [ROP], bronchopulmonary dysplasia [BPD], periventricular leukomalacia [PVL], necrotizing enterocolitis [NEC], death).

Results

Maternal age was significantly older in IVF group (34.9±0.9 vs. 33.0±0.4, P=0.03). The Apgar score 1 minute of the IVF group was significantly lower than control group (4.0±0.3 vs. 4.8±0.2, P=0.03). But there were no other significant differences of neonatal morbidities. In univariate logistic regression analysis with IVF, the odds ratio of maternal age was 1.13 (95% confidence interval: 1.01–1.27, P=0.04). The relative risk of RDS, BPD, PVL, and ROP was increased, but it was not significant in univariate and multivariate logistic regression.

Conclusion

As the maternal age increased, IVF pregnancy was significantly higher. The relative risk of RDS, BPD, PVL, and ROP was high in IVF group, but it was not significant in univariate and multivariate logistic regression.

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Table 1.
Maternal Characteristics and Morbidities between Two Groups
  Control group (n=112) IVF group (n=24) P-value
Maternal age (years) 33.0±0.4 34.9±0.9 0.03
PROM (hour) 15.3±3.8 35.2±21.5 NS
Pre-eclampsia (%) 32 (29.0) 6 (26.0) NS
Chorioamnionitis (%) 39 (46.0) 6 (40.0) NS
Antenatal corticosteroid (%) 68 (61.0) 17 (81.0) NS
C-sec (%) 87 (78.0) 17 (71.0) NS

Abbreviations: IVF, in vitro fertilization; PROM, premature rupture of membrane; NS, non-specific; C-sec, Cesarean section.

Table 2.
Neonatal Characteristics and Outcomes between Two Groups
  Control group (n=112) IVF group (n=24) P-value
Gestational age (weeks) 30.4±0.3 29.6±0.6 NS
Birth weight (g) 1,477.4±46.6 1,382.5±1,04.5 NS
Male 63 (56.0) 15 (63.0) NS
1 min Apgar 4.8±0.2 4.0±0.3 0.04
5 min Apgar 6.3±0.1 6.0±0.3 0.19
Length (cm) 39.8±0.4 38.9±0.1 NS
Head circumference (cm) 28.1±0.3 27.1±0.7 0.13
Hospital duration (day) 47.3±2.0 53.7±5.3 NS
Duration of intubation (day) 8.1±1.2 10.4±2.4 NS
Duration of O2 treatment (day) 1.6±0.2 1.3±0.4 NS
NEC 11 (10.0) 0 (0) NS
ROP 8 (7.0) 4 (16.0) NS
RDS 87 (78.0) 21 (88.0) NS
PDA 25 (22.0) 5 (21.0) NS
BPD 21 (19.0) 7 (29.0) NS
PVL 2 (2.0) 1 (4.0) NS
Death 2 (2.0) 0 (0) NS

Values are presented as mean±standard deviation or number (%). Abbreviations: IVF, in vitro fertilization; NS, non-specific; NEC, necrotizing entero- colitis; ROP, retinopathy of prematurity; RDS, respiratory distress syndrome; PDA, patent ductus arteriosus; BPD, bronchopulmonary dysplasia; PVL, periventricular leukomalacia.

Table 3.
Univariate Logistic Regression Analysis with In Vitro Fertilization
  Unadjusted OR 95% CI P-value
Maternal age* 1.13 1.01–1.27 0.04
† RDS 1.22 0.38–3.94 NS
† BPD 1.78 0.66–4.85 NS
† PVL 2.39 20.21–27.49 NS
† ROP 2.60 0.71–9.47 NS

*Independent variables.

Dependent varibles. Abbreviations: OR, odds ratio; CI, confidence interval; RDS, respiratory distress syndrome; NS, non-specific; BPD, bronchopulmonary dysplasia; PVL, periventricular leukomalacia; ROP, retinopathy of prematurity.

Table 4.
Multivariate Logistic Regression Analysis for Perinatal Morbidities
Adjusted variables RDS BPD PVL ROP
OR P-value OR P-value OR P-value OR P-value
IVF 1.16 NS 0.77 NS 3.93 NS 2.48 NS
Gestational age 0.85 NS 0.75 NS 1.24 NS 0.69 NS
Birth weight 1.00 NS 0.99 0.02 0.99 NS 0.99 NS
1 min Apgar 0.99 NS 1.06 NS 1.36 NS 1.04 NS
PROM 0.99 NS 0.99 NS 0.99 NS 0.98 NS
Pre-eclampsia 0.54 NS 0.32 NS 1.08 NS 0.25 NS

Abbreviations: RDS, respiratory distress syndrome; BPD, bronchopulmonary dysplasia; PVL, periventricular leukomalacia; ROP, retinopathy of prematurity; OR, odds ratio; IVF, in vitro fertilization; NS, non-specific; PROM, premature rupture of membranes.

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