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Extremities of body mass index and their association with pregnancy outcomes in women undergoing in vitro fertilization in the United States
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12 2016
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Source: Fertil Steril. 106(7):1742-1750
[PDF-569.01 KB]
Details:
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Alternative Title:Fertil Steril
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Personal Author:
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Description:Objective:
To investigate the associations among underweight body mass index (BMI), pregnancy, and obstetric outcomes among women using assisted reproductive technology (ART).
Design:
Retrospective cohort study using national data and log binomial regression.
Setting:
Not applicable.
Patient(s):
Women undergoing IVF in the United States from 2008 to 2013.
Intervention(s):
None.
Main Outcome Measure(s):
Pregnancy outcomes (intrauterine pregnancy, live birth rates) per transfer, miscarriage rate per pregnancy, and low birth weight and preterm delivery rates among singleton and twin pregnancies.
Result(s):
For all fresh autologous in vitro fertilization (IVF) cycles in the United States from 2008 to 2013 (n = 494,097 cycles, n = 402,742 transfers, n = 180,855 pregnancies) reported to the national ART Surveillance System, compared with normal weight women, underweight women had a statistically significant decreased chance of intrauterine pregnancy (adjusted risk ratio [aRR] 0.97; 95% confidence interval [CI], 0.96–0.99) and live birth (aRR 0.95; 95% CI, 0.93–0.98) per transfer. Obese women also had a statistically decreased likelihood of both (aRR 0.94; 95% CI, 0.94–0.95; aRR 0.87; 95% CI, 0.86–0.88, respectively). Among cycles resulting in singleton pregnancy, both underweight and obese statuses were associated with increased risk of low birth weight (aRR 1.39; 95% CI, 1.25–1.54, aRR 1.26; 95% CI, 1.20–1.33, respectively) and preterm delivery (aRR 1.12; 95% CI, 1.01–1.23, aRR 1.42; 95% CI, 1.36–1.48, respectively). The association between underweight status and miscarriage was not statistically significant (aRR 1.04; 95% CI, 0.98–1.11). In contrast, obesity was associated with a statistically significantly increased miscarriage risk (aRR 1.23; 95% CI, 1.20–1.26).
Conclusion(s):
Among women undergoing IVF, prepregnancy BMI affects pregnancy and obstetric outcomes. Underweight status may have a limited impact on pregnancy and live-birth rates, but it is associated with increased preterm and low-birth-weight delivery risk. Obesity negatively impacts all ART and obstetric outcomes investigated.
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Source:
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Pubmed ID:27666564
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Pubmed Central ID:PMC11056966
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