Baby Buzz A study in the November issue of Obstetrics & Gynecology finds that assisted reproductive technology (ART) does not increase risk for certain serious adverse outcomes. The study also confirms earlier findings that in vitro fertilization (IVF), the most common form of ART, raises the risk of some less-severe complications.
The Details Researchers followed 36,062 mothers taking part in a separate federally funded study between 1999 and 2002. There were three groups: 34,286 in the natural conception group, 554 in the IVF group and 1,222 in the ovulation-induction group (whose members were given medications to stimulate ovulation). The study -- which involved only the births of single babies, not twins, triplets or other multiples -- concluded that IVF "does not seem to be linked to an increase in major morbidities of pregnancy that include having a very small baby, having a baby with a birth defect as a result of treatment or having a baby that's born with a chromosome problem as a result of treatment," said lead study author Tracy Shevell, a perinatologist at Stamford Hospital in Connecticut.
The IVF group had a higher risk for some less serious problems, but it's not known if this was due to IVF or an unknown infertility-related cause, Shevell said. Compared with the control group, those who had the IVF procedure were 2.7 times more likely to develop preeclampsia (pregnancy-induced high blood pressure), 2.4 times more likely to have a placental abruption (where the placenta separates prematurely), six times more likely to have placenta previa (where the placenta implants too low in uterus), and 2.3 times more likely to have a Caesarean delivery. The ovulation group was 2.4 times more likely as the controls to have a placental abruption and 2.1 times more likely to have a fetal loss after 24 weeks. About 3 percent of all "pregnancies will be complicated by a birth defect," Shevell said, so "it's important to realize that if a patient does have IVF and gets pregnant and the baby does have a problem," the procedure may not be the cause.
Risky Business The most serious risk facing ART patients is multiple births, said Julia Johnson, vice chairman of gynecology at the University of Vermont College of Medicine and co-author of a report from a committee of the American College of Obstetricians and Gynecologists that accompanied the study. ART has been linked to a "30-fold increase in multiple pregnancies compared with the rate of spontaneous [natural] twin pregnancies," the report says. Multiple births boost risk for "poor maternal and infant health outcomes, including pregnancy complications, preterm delivery, low birth weight, congenital malformations and infant death," according to the Centers for Disease Control and Prevention.
-- January W. Payne