Extremities of body mass index and their association with pregnancy outcomes in women undergoing in vitro fertilization in the United States

Details

• Alternative Title:
  Fertil Steril
• Personal Author:
  Kawwass, Jennifer F. ; Kulkarni, Aniket D. ; Hipp, Heather S. ; Crawford, Sara ; Kissin, Dmitry M. ; Jamieson, Denise J.
• 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.
  More +
• Subjects:
  • Abortion, Spontaneous
  • Adult
  • Birth Weight
  • Body Mass Index
  • Databases, Factual
  • Female
  • Fertility
  • Fertilization in Vitro
  • Gestational Age
  • Humans
  More +
• Keywords:
  • IVF
  • miscarriage
  • outcomes
  • preterm
  • underweight
• Source:
  Fertil Steril. 106(7):1742-1750
• Pubmed ID:
  27666564
• Pubmed Central ID:
  PMC11056966
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  106
• Issue:
  7
• Download URL:
  https://stacks.cdc.gov/view/cdc/155086/cdc_155086_DS1.pdf
• File Type:
  [PDF - 569.01 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:ba29a35abd758b24c8f03c1c0cb9c15b778f2f9cdf7e3d973aad742c2a511f2e