Table 4.
Adjusted odds ratios comparing the obstetric and delivery outcomes of ART-treated and subfertile to fertile women stratified by age of mother and by delivery complications among singleton, vaginal deliveries
| Group | Prematurity (< 37 weeks) | LBW (< 2500 g) | Fetal/perinatal death (≥ 20 weeks–7 days) | Maternal delivery prolonged LOS | |||||
|---|---|---|---|---|---|---|---|---|---|
| % | AOR (95% CI) | % | AOR (95% CI) | % | AOR (95% CI) | % | AOR (95% CI) | ||
| Age category1 | |||||||||
| Age ≤ 30 | Fertile | 6.8 | 1.00 (referent) | 6.2 | 1.00 (referent) | 0.7 | 1.00 (referent) | 8.9 | 1.00 (referent) |
| Subfertile | 9.5 | 1.52 (1.09–2.13) | 8.8 | 1.79 (1.27–2.54) | 2.4 | 5.03 (2.62–9.64) | 11.9 | 1.33 (0.97–1.81) | |
| ART | 12.8 | 2.11 (1.65–2.71) | 9.6 | 2.02 (1.52–2.67) | 1.5 | 2.80 (1.41–5.58) | 11.9 | 1.33 (1.02–1.72) | |
| Age 31–34 | Fertile | 6.4 | 1.00 (referent) | 5.4 | 1.00 (referent) | 0.6 | 1.00 (referent) | 9.7 | 1.00 (referent) |
| Subfertile | 6.4 | 0.98 (0.67–1.45) | 6.4 | 1.27 (0.86–1.88) | 2.2 | 3.55 (1.76–7.18) | 9.9 | 1.04 (0.76–1.44) | |
| ART | 9.7 | 1.53 (1.23–1.91) | 7.6 | 1.49 (1.17–1.91) | 1.3 | 2.03 (1.11–3.72) | 11.5 | 1.23 (1.00–1.51) | |
| Age 35–39 | Fertile | 7.9 | 1.00 (referent) | 6.7 | 1.00 (referent) | 0.7 | 1.00 (referent) | 12.2 | 1.00 (referent) |
| Subfertile | 10.0 | 1.29 (0.94–1.79) | 7.6 | 1.20 (0.83–1.72) | 0.7 | 1.00 (0.31–3.26) | 13.5 | 1.02 (0.77–1.37) | |
| ART | 9.6 | 1.24 (0.99–1.55) | 8.2 | 1.29 (1.01–1.63) | 0.6 | 0.89 (0.38–2.09) | 16.0 | 1.33 (1.11–1.59) | |
| Age ≥ 40 | Fertile | 10.0 | 1.00 (referent) | 8.1 | 1.00 (referent) | 2.0 | 1.00 (referent) | 17.4 | 1.00 (referent) |
| Subfertile | 9.2 | 1.00 (0.58–1.75) | 8.1 | 1.08 (0.59–1.95) | 1.2 | 0.67 (0.15–3.00) | 21.4 | 1.30 (0.86–1.95) | |
| ART | 8.4 | 0.88 (0.60–1.30) | 6.5 | 0.82 (0.53–1.26) | 0.2 | 0.11 (0.01–0.86) | 25.9 | 1.58 (1.21–2.05) | |
| Pregnancy and delivery complication category | |||||||||
| No complications2 | Fertile | 4.3 | 1.00 (referent) | 4.3 | 1.00 (referent) | 0.6 | 1.00 (referent) | 4.4 | 1.00 (referent) |
| Subfertile | 5.3 | 1.40 (1.00–1.95) | 4.9 | 1.48 (1.05–2.10) | 1.8 | 3.66 (2.04–6.57) | 5.6 | 1.08 (0.78–1.50) | |
| ART | 5.8 | 1.47 (1.15–1.87) | 4.0 | 1.22 (0.92–1.62) | 0.8 | 1.59 (0.84–2.98) | 7.9 | 1.49 (1.20–1.83) | |
| Placental complications and bleeding3 | Fertile | 17.6 | 1.00 (referent) | 16.0 | 1.00 (referent) | 3.1 | 1.00 (referent) | 16.3 | 1.00 (referent) |
| Subfertile | 25.3 | 1.42 (0.84–2.41) | 19.8 | 1.30 (0.74–2.29) | 7.7 | 3.36 (1.32–8.54) | 17.6 | 0.84 (0.46–1.52) | |
| ART | 19.1 | 1.08 (0.75–1.55) | 16.0 | 1.11 (0.76–1.62) | 1.9 | 0.63 (0.22–1.83) | 26.7 | 1.55 (1.12–2.14) | |
| Fetal distress4 | Fertile | 5.4 | 1.00 (referent) | 6.0 | 1.00 (referent) | 0.1 | 1.00 (referent) | 12.3 | 1.00 (referent) |
| Subfertile | 4.7 | 0.76 (0.42–1.39) | 5.8 | 1.04 (0.61–1.76) | 0.4 | 4.65 (1.07–20.22) | 15.7 | 1.14 (0.80–1.63) | |
| ART | 9.4 | 1.62 (1.18–2.22) | 9.0 | 1.55 (1.14–2.11) | 0.2 | 2.14 (0.51–8.88) | 15.6 | 1.08 (0.84–1.39) | |
| Prolonged/dysfunctional labor5 | Fertile | 4.7 | 1.00 (referent) | 4.3 | 1.00 (referent) | 0.3 | 1.00 (referent) | 19.3 | 1.00 (referent) |
| Subfertile | 1.6 | 0.30 (0.07–1.31) | 3.2 | 1.03 (0.36–2.97) | 0.0 | – | 19.8 | 0.72 (0.43–1.21) | |
| ART | 3.9 | 1.03 (0.50–2.10) | 4.8 | 1.66 (0.86–3.21) | 0.4 | 3.93 (0.88–17.55) | 26.8 | 1.23 (0.87–1.73) | |
LBW low birthweight, LOS length of stay
1Multivariable logistic regression models adjusted for maternal age, race, insurance, education, marital status, diabetes, chronic hypertension, previous uterine surgery, gestational diabetes, pregnancy hypertension, bleeding, and placenta complications
2Adjusted for maternal age, race, insurance, education, and marital status
3.Adjusted for maternal age, race, insurance, education, marital status, diabetes, chronic hypertension, previous uterine surgery, gestational diabetes, pregnancy hypertension, breech/malpresentation, prolonged labor (> 20 h), dysfunctional labor, fetal distress, cord prolapse, PROM, and cephalopelvic disproportion
4.Adjusted for maternal age, race, insurance, education, marital status, diabetes, chronic hypertension, previous uterine surgery, gestational diabetes, pregnancy hypertension, bleeding, placenta complications, breech/malpresentation, prolonged labor (> 20 h), dysfunctional labor, cord prolapse, PROM, and cephalopelvic disproportion
5.Adjusted for maternal age, race, insurance, education, marital status, diabetes, chronic hypertension, previous uterine surgery, gestational diabetes, pregnancy hypertension, bleeding, placenta complications, breech/malpresentation, fetal distress, cord prolapse, PROM, and cephalopelvic disproportion