No increased risk of major congenital anomalies or adverse pregnancy or neonatal outcomes following letrozole use in assisted reproductive technology

ObjectiveTo investigate the association between pre-pregnancy body mass index (BMI) and miscarriages in women who required assisted reproductive technology (ART) for conception.MethodsA retrospective cohort study was conducted using a 10-year (2006–2015) sample of 14,994 pregnancy cycles with ART treatment in Northwest Women’s and Children’s Hospital, Xi’an, China. The effects of women’s BMI before pregnancy on early miscarriage and miscarriage were assessed using generalized estimating equation models.ResultsThe risks of early miscarriage and miscarriage were higher in the obese group than in the normal weight group [early miscarriage: relative risk (RR) = 1.36, confidence interval (CI): 1.12–1.65; miscarriage: RR = 1.40, 95% CI: 1.17–1.68]. Pre-pregnancy underweight was not associated with an increased risk of early miscarriage or miscarriage. We observed interactions between pre-pregnancy BMI and singleton or twin pregnancy in early miscarriage and miscarriage (P = 0.017 and P = 0.003, respectively). Twin pregnancy increased the effects of pre-pregnancy BMI on early miscarriage and miscarriage (early miscarriage: a. singleton pregnancy: RR = 1.02, 95% CI: 1.01–1.04; b. twin pregnancy: RR = 1.08, 95% CI: 1.03–1.13; miscarriage: a. singleton pregnancy: RR = 1.02, 95% CI: 1.01–1.04; b. twin pregnancy: RR = 1.08, 95% CI: 1.05–1.13).ConclusionsPre-pregnancy obesity was associated with higher risks of early miscarriage and miscarriage in the ART population, and twin pregnancy increased the effects of pre-pregnancy BMI on early miscarriage and miscarriage. Women should maintain a normal BMI before ART initiation to prevent adverse pregnancy outcomes.

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The influence of obesity on perinatal outcomes in pregnancies achieved with assisted reproductive technology: A population-based retrospective cohort study

Obstetric Medicine ◽

10.1177/1753495x15621152 ◽

2016 ◽

Vol 9 (1) ◽

pp. 34-39 ◽

Cited By ~ 4

Author(s):

Amy M Valent ◽

Eric S Hall ◽

Emily A DeFranco

Keyword(s):

Cohort Study ◽

Assisted Reproductive Technology ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Tertiary Care ◽

Population Based ◽

Reproductive Technology ◽

Neonatal Outcomes ◽

Increased Risk ◽

Adverse Neonatal Outcomes

Objective To determine the influence of obesity on neonatal outcomes of pregnancies resulting from assisted reproductive technology. Methods Population-based retrospective cohort study of all non-anomalous, live births in Ohio from 2007 to 2011, comparing differences in the frequency of adverse neonatal outcomes of women who conceived with assisted reproductive technology versus spontaneously conceived pregnancies and stratified by obesity status. Primary outcome was a composite of neonatal morbidities defined as ≥1 of the following: neonatal death, Apgar score of <7 at 5 min, assisted ventilation, neonatal intensive care unit admission, or transport to a tertiary care facility. Results Rates of adverse neonatal outcomes were significantly higher for assisted reproductive technology pregnancies than spontaneously conceived neonates; non-obese 25% versus 8% and obese 27% versus 10%, p < 0.001. Assisted reproductive technology was associated with a similar increased risk for adverse outcomes in both obese (adjusted odds ratio (aOR): 1.33, 95% confidence interval (CI): 1.11–1.59) and non-obese women (aOR: 1.34, 95% CI: 1.18–1.51) even after adjustment for coexisting risk factors. This increased risk was driven by higher preterm births in assisted reproductive technology pregnancies; obese (aOR: 1.06, 95% CI: 0.86–1.31) and non-obese (aOR: 1.15, 95% CI: 1.00–1.32). Discussion Assisted reproductive technology is associated with a higher risk of adverse neonatal outcomes. Obesity does not appear to adversely modify perinatal risks associated with assisted reproductive technology.

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Effect of advanced maternal age on maternal and neonatal outcomes in assisted reproductive technology pregnancies

European Journal of Obstetrics & Gynecology and Reproductive Biology ◽

10.1016/j.ejogrb.2017.07.029 ◽

2017 ◽

Vol 216 ◽

pp. 178-183 ◽

Cited By ~ 5

Author(s):

Amirhossein Moaddab ◽

Frank A. Chervenak ◽

Laurence B. Mccullough ◽

Haleh Sangi-Haghpeykar ◽

Amir A. Shamshirsaz ◽

...

Keyword(s):

Assisted Reproductive Technology ◽

Maternal Age ◽

Advanced Maternal Age ◽

Reproductive Technology ◽

Neonatal Outcomes ◽

Maternal And Neonatal Outcomes

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Maternal and Neonatal Outcomes Associated with Psychostimulant Use in Pregnancy

International Journal for Population Data Science ◽

10.23889/ijpds.v5i5.1579 ◽

2020 ◽

Vol 5 (5) ◽

Author(s):

Ximena Camacho ◽

Alys Havard ◽

Helga Zoega ◽

Margaret Wilson ◽

Tara Gomes ◽

...

Keyword(s):

Birth Outcomes ◽

Neonatal Intensive Care ◽

Low Birthweight ◽

Cohort Analysis ◽

Neonatal Outcomes ◽

Increased Risk ◽

The Usa ◽

Maternal And Neonatal Outcomes ◽

Adverse Pregnancy ◽

In Pregnancy

IntroductionRecent evidence from the USA and Nordic countries suggests a possible association between psychostimulant use during gestation and adverse pregnancy and birth outcomes. Objectives and ApproachWe employed a distributed cohort analysis using linked administrative data for women who gave birth in New South Wales (NSW; Australia) and Ontario (Canada), whereby a common protocol was implemented separately in each jurisdiction. The study population comprised women who were hospitalized for a singleton delivery over an 8 (NSW) and 4 (Ontario) year period, respectively, with the NSW cohort restricted to social security beneficiaries. Psychostimulant exposure was defined as at least one dispensing of methylphenidate, amphetamine, dextroamphetamine or lisdexamfetamine during pregnancy. We examined the risk of maternal and neonatal outcomes among psychostimulant exposed mothers compared with unexposed mothers. ResultsThere were 140,356 eligible deliveries in NSW and 449,499 in Ontario during the respective study periods. Fewer than 1% of these pregnancies were exposed to psychostimulants during gestation, although use was higher in Ontario (0.30% vs 0.11% in NSW). Preliminary unadjusted analyses indicated possible associations between psychostimulant use in pregnancy and higher risks of pre-term birth (relative risk [RR] 1.7, 95% confidence interval [CI] 1.4-2.0 (Ontario); RR 1.8, 95% CI 1.2-2.6 (NSW)) and pre-eclampsia (RR 2.0, 95% CI 1.5-2.6 (Ontario); RR 2.0, 95% CI 1.2-3.5 (NSW)). Similarly, psychostimulant use was associated with higher risks of low birthweight (RR 1.6, 95% CI 1.3-1.9 (Ontario); RR 2.0, 95% CI 1.3-3.0 (NSW)) and admission to neonatal intensive care (RR 2.1, 95% CI 1.9-2.3 (Ontario); RR 1.5, 95% CI 1.1-1.9 (NSW)). Conclusion / ImplicationsUnadjusted analyses indicate an increased risk of adverse maternal and birth outcomes associated with psychostimulant exposure during pregnancy, potentially representing a placental effect. We are currently refining the analyses, employing propensity score methods to adjust for confounding.

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Association of assisted reproductive technology with twinning and congenital anomalies

The Indian Journal of Pediatrics ◽

10.1007/s12098-008-0123-5 ◽

2008 ◽

Vol 75 (6) ◽

pp. 638-640 ◽

Cited By ~ 4

Author(s):

Sevim Balci ◽

Ozlem Engiz ◽

Mehmet Alikasifoglu ◽

Ibrahim Esinler ◽

M. Sinan Beksac

Keyword(s):

Assisted Reproductive Technology ◽

Congenital Anomalies ◽

Reproductive Technology

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Assisted reproductive technology pregnancies were associated with an increased risk of specific negative outcomes

Evidence-based Obstetrics and Gynaecology ◽

10.1016/j.ebobgyn.2006.07.002 ◽

2006 ◽

Vol 8 (3-4) ◽

pp. 110-111

Keyword(s):

Assisted Reproductive Technology ◽

Reproductive Technology ◽

Negative Outcomes ◽

Increased Risk

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Assisted reproductive technology is not associated with an increased risk of pediatric cancer

Fertility and Sterility ◽

10.1016/j.fertnstert.2018.07.064 ◽

2018 ◽

Vol 110 (4) ◽

pp. e16-e17 ◽

Cited By ~ 1

Author(s):

D. Gilboa ◽

G. Koren ◽

R. Katz ◽

R. Rotem ◽

E. Lunenfeld

Keyword(s):

Assisted Reproductive Technology ◽

Pediatric Cancer ◽

Reproductive Technology ◽

Increased Risk

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No specific adverse pregnancy outcome in singleton pregnancies after assisted reproductive technology (ART) for unexplained infertility

Journal of Gynecology Obstetrics and Human Reproduction ◽

10.1016/j.jogoh.2019.08.006 ◽

2020 ◽

Vol 49 (1) ◽

pp. 101623

Author(s):

M. Amouyal ◽

M. Boucekine ◽

O. Paulmyer-Lacroix ◽

A. Agostini ◽

F. Bretelle ◽

...

Keyword(s):

Assisted Reproductive Technology ◽

Pregnancy Outcome ◽

Adverse Pregnancy Outcome ◽

Reproductive Technology ◽

Unexplained Infertility ◽

Adverse Pregnancy ◽

Singleton Pregnancies

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Assisted Reproductive Technology and Origins of Disease: The Clinical Realities and Implications

Seminars in Reproductive Medicine ◽

10.1055/s-0038-1677048 ◽

2018 ◽

Vol 36 (03/04) ◽

pp. 195-203

Author(s):

Emre Seli ◽

Scott Morin

Keyword(s):

Assisted Reproductive Technology ◽

Premature Birth ◽

Absolute Risk ◽

Reproductive Technology ◽

Multiple Gestation ◽

Male Factor Infertility ◽

Male Factor ◽

Monogenic Disorder ◽

Increased Risk ◽

Confounding Variables

AbstractThe majority of offspring born following assisted reproductive technology (ART) achieve equivalent development milestones and demonstrate comparable health as spontaneously conceived children. Yet, multiple studies have suggested offspring conceived with ART have slightly increased risk of metabolic derangements, cardiovascular disease, and malignancy. However, the associations observed in these studies often inadequately control for a variety of confounding variables, such as multiple gestation, premature birth, and low birth weight. Furthermore, many studies fail to account for the increased risk of many of these pathologies in the offspring of subfertile women in general. Lastly, the absolute risk of most of the ailments studied is extremely low. In nearly all examples, the number of women who would need to be treated to observe one additional diagnosis is substantially high. When compared with the number of couples who would have remained childless due to severe male factor infertility or would have been exposed to the risk of passing on a severe monogenic disorder, the general increased risks to ART-exposed children is very small.

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Safety of Antimicrobials During Pregnancy: A Systematic Review of Antimicrobials Considered for Treatment and Postexposure Prophylaxis of Plague

Clinical Infectious Diseases ◽

10.1093/cid/ciz1231 ◽

2020 ◽

Vol 70 (Supplement_1) ◽

pp. S37-S50 ◽

Cited By ~ 2

Author(s):

Patricia A Yu ◽

Emmy L Tran ◽

Corinne M Parker ◽

Hye-Joo Kim ◽

Eileen L Yee ◽

...

Keyword(s):

Spontaneous Abortion ◽

Case Reports ◽

Case Series ◽

First Trimester ◽

Neonatal Outcomes ◽

Primary Sources ◽

Limited Data ◽

Postexposure Prophylaxis ◽

Increased Risk ◽

Adverse Pregnancy

Abstract Background The safety profile of antimicrobials used during pregnancy is one important consideration in the decision on how to treat and provide postexposure prophylaxis (PEP) for plague during pregnancy. Methods We searched 5 scientific literature databases for primary sources on the safety of 9 antimicrobials considered for plague during pregnancy (amikacin, gentamicin, plazomicin, streptomycin, tobramycin, chloramphenicol, doxycycline, sulfadiazine, and trimethoprim-sulfamethoxazole [TMP-SMX]) and abstracted data on maternal, pregnancy, and fetal/neonatal outcomes. Results Of 13 052 articles identified, 66 studies (case-control, case series, cohort, and randomized studies) and 96 case reports were included, totaling 27 751 prenatal exposures to amikacin (n = 9), gentamicin (n = 345), plazomicin (n = 0), streptomycin (n = 285), tobramycin (n = 43), chloramphenicol (n = 246), doxycycline (n = 2351), sulfadiazine (n = 870), and TMP-SMX (n = 23 602). Hearing or vestibular deficits were reported in 18/121 (15%) children and 17/109 (16%) pregnant women following prenatal streptomycin exposure. First trimester chloramphenicol exposure was associated with an elevated risk of an undescended testis (odds ratio [OR] 5.9, 95% confidence interval [CI] 1.2–28.7). Doxycycline was associated with cardiovascular malformations (OR 2.4, 95% CI 1.2–4.7) in 1 study and spontaneous abortion (OR 2.8, 95% CI 1.9–4.1) in a separate study. First trimester exposure to TMP-SMX was associated with increased risk of neural tube defects (pooled OR 2.5, 95% CI 1.4–4.3), spontaneous abortion (OR 3.5, 95% CI 2.3–5.6), preterm birth (OR 1.5, 95% CI 1.1–2.1), and small for gestational age (OR 1.6, 95% CI 1.2–2.2). No other statistically significant associations were reported. Conclusions For most antimicrobials reviewed, adverse maternal/fetal/neonatal outcomes were not observed consistently. Prenatal exposure to streptomycin and TMP-SMX was associated with select birth defects in some studies. Based on limited data, chloramphenicol and doxycycline may be associated with adverse pregnancy or neonatal outcomes; however, more data are needed to confirm these associations. Antimicrobials should be used for treatment and PEP of plague during pregnancy; the choice of antimicrobials may be influenced by these data as well as information about the risks of plague during pregnancy.

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