ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2019
Infertility treatment and risk of severe maternal morbidity: a propensity score-matched cohort study.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
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Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 70 citations in OpenAlex.
- Caesarean section in pregnancies conceived by assisted reproductive technology: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2021Pooled it
- Establishment of a predictive model for postpartum hemorrhage in twins: a retrospective study.BMC pregnancy and childbirth · 2023Trial
- Long-term maternal health outcomes following autologous in vitro fertilization compared with medically unassisted conceptions and with nulliparas.Journal of assisted reproduction and genetics · 2026Article
- Long-term risk of cardiovascular disease after assisted reproductive technology and infertility: A cohort study.PLoS medicine · 2026Article
- The Association Between Infertility Treatment and Birth Outcomes for Nulliparous Persons Who Gave Birth 35 Years and Older: Findings from 2022 National Vital Statistics System Natality Data.Maternal and child health journal · 2025Article
- Adverse Obstetric and Perinatal Outcomes Among Birthing People in Same-Sex and Different-Sex Relationships in Louisiana.LGBT health · 2025Article
- Racial/ethnic disparity in severe maternal morbidity among women who conceived by in vitro fertilization.AJOG global reports · 2024Article
- Trends in maternal ICU admissions at a quaternary centre in Montreal, Canada, and impact of maternal age on critical care outcomes.Obstetric medicine · 2024Article
- Multifetal Pregnancy After Implementation of a Publicly Funded Fertility Program.JAMA network open · 2024Article
- The risk of perinatal and cardiometabolic complications in pregnancies conceived by medically assisted reproduction.Journal of assisted reproduction and genetics · 2024Article
- Improved reproductive outcomes in normogonadotropic oligomenorrheic women undergoing ovarian stimulation with intrauterine insemination: a retrospective cohort analysis of real-world data.Frontiers in endocrinology · 2024Article
- Infertility and Risk of Autism Spectrum Disorder in Children.JAMA network open · 2023Article
- Neighborhood Income Mobility and Risk of Neonatal and Maternal Morbidity.JAMA network open · 2023Article
- Novel Time-Lapse Parameters Correlate with Embryo Ploidy and Suggest an Improvement in Non-Invasive Embryo Selection.Journal of clinical medicine · 2023Article
- Pregnancy after breast cancer in BRCA1/2 mutation carriers.Hereditary cancer in clinical practice · 2022Review
- Placental Dysfunction in Assisted Reproductive Pregnancies: Perinatal, Neonatal and Adult Life Outcomes.International journal of molecular sciences · 2022Review
- Article
- Data Resource Profile: Better Outcomes Registry & Network (BORN) Ontario.International journal of epidemiology · 2021Article
- Article
- Neighbourhood material deprivation and severe maternal morbidity: a population-based cohort study in Ontario, Canada.BMJ open · 2021Article
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe extent to which infertility treatment predicts severe maternal morbidity is not well known. We examined the association between infertility treatment and severe maternal morbidity in pregnancy and the postpartum period.
methodsWe conducted a cohort study using population-based registries from Ontario between 2006 and 2012. Pregnancies achieved using infertility treatment (ovulation induction, intrauterine insemination or in vitro fertilization with or without intracytoplasmic sperm injection) were compared with unassisted pregnancies using propensity score matching, based on demographic, reproductive and obstetric factors. The primary outcome was a validated composite of severe maternal morbidity or maternal death from 20 weeks' gestation to 42 days postpartum. We also calculated the odds ratio of a woman having 1, 2, or 3 or more severe maternal morbidity indicators in relation to invasive (e.g., in vitro fertilization) or noninvasive (e.g., intrauterine insemination) infertility treatment.
resultsWe matched 11 546 infertility treatment pregnancies with 47 553 untreated pregnancies. Severe maternal morbidity or maternal death occurred in 356 infertility-treated pregnancies (30.8 per 1000 deliveries) versus 1054 untreated pregnancies (22.2 per 1000 deliveries); relative risk 1.39 (95% confidence interval [CI] 1.23-1.56). The likelihood of a woman having 3 or more severe maternal morbidity indicators was increased in women who received invasive infertility treatment (odds ratio [OR] 2.28, 95% CI 1.56-3.33) but not in those who received noninvasive infertility treatment (OR 0.99, 95% CI 0.57-1.72).
interpretationWomen who undergo infertility treatment, particularly in vitro fertilization, are at somewhat higher risk of severe maternal morbidity or death. Efforts are needed to identify patient- and treatment-specific predictors of severe maternal morbidity that may influence the type of treatment a woman is offered.
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