Evidence map›Paper›PMID 30696425›Full record

ArticleBMC pregnancy and childbirth2019

Singleton pregnancies after in vitro fertilization in Estonia: a register-based study of complications and adverse outcomes in relation to the maternal socio-demographic background.

Kaja Rahu, Kärt Allvee, Helle Karro, Mati Rahu

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC pregnancy and childbirth, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
8.0field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 24 citations in OpenAlex.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Kaja RahuDepartment of Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia. kaja.rahu@tai.ee.ORCID http://orcid.org/0000-0001-9693-7540
Kärt AllveeEstonian Medical Birth Registry, National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia.
Helle KarroDepartment of Obstetrics and Gynecology, Institute of Clinical Medicine, University of Tartu, L. Puusepa 8, 51014, Tartu, Estonia.
Mati RahuDepartment of Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia.
National Institute for Health Development · EETartu University Hospital · EE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAn increased risk of adverse conditions related to in vitro fertilization (IVF) pregnancies has been repeatedly reported. Our study aimed to summarize outcome differences between pregnancies after IVF and after spontaneous conception (SC) in Estonia.

methodsData on all liveborn singletons to primiparas women aged 25-40 years during the period 2005-2014 were obtained from the Estonian Medical Birth Registry. There were 1778 and 33,555 newborns in the IVF and SC cohort, respectively. The relative risk of pregnancy-related complications and adverse pregnancy outcomes in the IVF cohort in comparison with the SC cohort was quantified by prevalence proportion ratios (RR) with 95% confidence intervals (CI) using modified Poisson regression models adjusted for maternal age, education, ethnicity, marital status and study period.

resultsThe cohort of IVF singletons experienced a higher risk of preterm birth (RR 1.51; 95% CI 1.28-1.78), iatrogenic preterm birth (RR 1.62; 95% CI 1.32-1.98), very preterm birth (RR 1.49; 95% CI 1.00-2.23), low birthweight (RR 1.47; 95% CI 1.20-1.80), congenital anomalies (RR 1.51; 95% CI 1.08-2.11), and admission to a neonatal intensive care unit (RR 1.13; 95% CI 1.01-1.26). Somewhat elevated risk of spontaneous preterm birth did not reach statistical significance (RR 1.32; 95% CI 0.97-1.80). IVF mothers were at increased risk of placenta previa (RR 7.15; 95% CI 4.04-12.66), placental abruption (RR 2.12; 1.43-3.14) and cesarean section (RR 1.28; 95% CI 1.20-1.37). The risk of pre-eclampsia was borderline (RR 1.25; 95% CI 0.98-1.59). Adjustment for maternal age attenuated the associations between IVF and adverse outcomes. Maternal education, ethnicity and marital status had no effect on the magnitude of the risk estimates.

conclusionsThe increased risk of pregnancy-related complications and adverse pregnancy outcomes was observed in the Estonian cohort of IVF singletons in comparison with the cohort of SC singletons. The relative risk estimates grew with maternal age but were not influenced by the maternal education, ethnicity and marital status. To monitor the efficacy and safety of the used assisted reproductive technology, a specialized country-wide register should be created in Estonia.

Indexed as

RegistriesAdultCesarean SectionEstoniaFemaleFertilization in VitroHumansInfant, Low Birth WeightInfant, NewbornInfant, PrematurePregnancyPregnancy ComplicationsPregnancy OutcomePremature BirthReproductive Techniques, AssistedYoung AdultIn vitro fertilizationPregnancy outcomePregnancy-related complicationsPrimiparaSingletonSocio-demographic background

Identifiers

PMID30696425
PMCPMC6352442
OpenAlexW2920359195

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.