TABLE 3.
Pregnancy, birth, and infant outcomes by maternal fertility group and plurality at birth
| Singletons |
Twins |
Triplets+ |
||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| IVF | IVF | IVF | ||||||||||||||||
| Fertile | Subfertile | Autologous- fresh |
Autologous- thawed |
Donor- fresh |
Donor- thawed |
Fertile | Subfertile | Autologous- fresh |
Autologous- thawed |
Donor- fresh |
Donor- thawed |
Fertile | Subfertile | Autologous- fresh |
Autologous- thawed |
Donor- fresh |
Donor- thawed |
|
| N, pregnancies | 1,326,650 | 9142 | 56,037 | 16,997 | 8129 | 3574 | 19,116 | 1951 | 22,858 | 4686 | 4921 | 1041 | 352 | 205 | 1359 | 281 | 168 | 55 |
| Diabetes, % | ||||||||||||||||||
| Pregestational diabetes | 0.6 | 0.9 | 0.7 | 0.7 | 0.8 | 1.0 | 0.8 | 1.0 | 0.6 | 0.7 | 0.7 | 1.1 | 0.6 | 1.0 | 1.5 | 0.7 | 3.0 | 0.0 |
| Gestational diabetes | 4.4 | 9.2 | 6.3 | 6.5 | 7.6 | 8.4 | 5.7 | 10.0 | 7.7 | 8.4 | 9.5 | 9.5 | 8.3 | 14.5 | 9.9 | 9.6 | 9.2 | 12.1 |
| Hypertension, % | ||||||||||||||||||
| Pregestational hypertension | 1.1 | 2.2 | 1.4 | 1.6 | 2.8 | 2.6 | 1.7 | 2.5 | 1.3 | 1.8 | 3.1 | 3.5 | 1.6 | 1.9 | 2.0 | 2.0 | 3.2 | 8.5 |
| Gestational hypertension | 3.5 | 6.5 | 4.2 | 5.0 | 8.6 | 7.4 | 7.7 | 11.1 | 8.8 | 12.3 | 18.4 | 15.4 | 9.4 | 16.9 | 13.4 | 18.3 | 29.4 | 19.9 |
| Preeclampsia | 0.2 | 0.3 | 0.3 | 0.2 | 0.6 | 0.4 | 0.6 | 0.9 | 0.6 | 0.6 | 1.2 | 0.5 | 1.2 | 0.8 | 0.9 | 1.2 | 2.5 | 0.0 |
| Mode of delivery, % | ||||||||||||||||||
| Vaginal | 67.6 | 56.4 | 54.6 | 46.3 | 32.5 | 31.6 | 25.2 | 21.8 | 18.0 | 16.2 | 10.8 | 12.5 | 6.9 | 3.8 | 4.4 | 5.9 | 3.2 | 1.8 |
| Cesarean | 32.4 | 43.6 | 45.4 | 53.7 | 67.5 | 68.4 | 74.8 | 78.2 | 82.0 | 83.8 | 89.2 | 87.5 | 93.1 | 96.2 | 95.6 | 94.1 | 96.8 | 98.2 |
| Repeat cesarean | 42.4 | 30.6 | 21.4 | 34.1 | 16.8 | 36.3 | 22.4 | 17.6 | 12.5 | 20.3 | 12.9 | 26.7 | 20.2 | 18.1 | 12.4 | 16.8 | 13.5 | 24.2 |
| Length of gestation | ||||||||||||||||||
| Wk, mean (SD) | 38.7 (2.0) | 38.4 (2.3) | 38.4 (2.2) | 38.5 (2.2) | 38.2 (2.4) | 38.0 (2.4) | 35.3 (3.1) | 34.9 (3.6) | 35.3 (3.0) | 35.3 (3.0) | 35.3 (2.9) | 35.2 (2.9) | 31.8 (3.3) | 31.8 (3.1) | 32.1 (3.2) | 32.0 (3.4) | 32.1 (2.9) | 32.4 (3.2) |
| <28 wk, % | 0.5 | 1.1 | 0.7 | 0.7 | 0.8 | 0.8 | 3.5 | 5.9 | 3.3 | 3.0 | 2.3 | 3.0 | 10.6 | 10.4 | 9.8 | 11.6 | 7.2 | 5.6 |
| 28–32 wk, % | 1.1 | 1.5 | 1.7 | 1.5 | 2.3 | 2.8 | 10.1 | 12.2 | 10.4 | 10.8 | 11.4 | 11.5 | 41.9 | 40.4 | 39.1 | 35.9 | 44.6 | 41.4 |
| 33–36 wk, % | 6.6 | 8.6 | 9.0 | 8.8 | 12.1 | 13.3 | 44.2 | 41.5 | 45.0 | 45.4 | 48.0 | 49.8 | 45.8 | 47.9 | 47.7 | 50.1 | 44.0 | 45.7 |
| ≥37 wk, % | 91.9 | 88.9 | 88.5 | 89.0 | 84.8 | 83.1 | 42.2 | 40.4 | 41.3 | 40.8 | 38.3 | 35.7 | 1.8 | 1.3 | 3.3 | 2.4 | 4.2 | 7.4 |
| Infant morbidity | ||||||||||||||||||
| NICU admission | 6.0 | 9.3 | 7.9 | 8.4 | 10.4 | 10.6 | 31.4 | 36.4 | 32.7 | 31.7 | 35.6 | 36.9 | 73.4 | 81.1 | 79.4 | 75.8 | 78.5 | 75.6 |
| Neonatal death | 0.2 | 0.6 | 0.2 | 0.3 | 0.2 | 0.3 | 1.3 | 2.8 | 1.0 | 0.9 | 0.7 | 1.0 | 3.9 | 2.4 | 2.9 | 2.6 | 0.8 | 1.2 |
| Infant death | 0.4 | 0.6 | 0.3 | 0.4 | 0.3 | 0.4 | 1.8 | 3.1 | 1.4 | 1.2 | 1.1 | 1.1 | 4.3 | 3.2 | 3.7 | 3.1 | 1.4 | 4.2 |
| Rates of severe maternal morbiditya | ||||||||||||||||||
| Any morbidity | 1179 | 2477 | 1875 | 2141 | 1993 | 1427 | 1297 | 1863 | 1251 | 2017 | 2205 | 2210 | 2812 | 3152 | 2011 | 4513 | 2786 | 5455 |
| Admission to intensive care | 125 | 139 | 182 | 200 | 381 | 420 | 393 | 373 | 335 | 683 | 904 | 721 | 1433 | 1778 | 883 | 2138 | 1791 | 0 |
| Blood transfusion | 207 | 405 | 312 | 424 | 590 | 559 | 745 | 1251 | 709 | 1206 | 1433 | 1201 | 1470 | 1890 | 1251 | 2850 | 1791 | 5455 |
| Ruptured uterus | 31 | 58 | 66 | 65 | 12 | 28 | 73 | 80 | 68 | 43 | 51 | 0 | 0 | 0 | 25 | 238 | 398 | 0 |
| Unplanned hysterectomy | 33 | 46 | 55 | 159 | 185 | 280 | 122 | 213 | 77 | 277 | 335 | 432 | 92 | 0 | 147 | 356 | 597 | 0 |
| Third- or fourth-degree perineal lacerationb | 1231 | 3477 | 2506 | 3205 | 3254 | 1596 | 620 | 1230 | c | c | c | c | c | c | c | c | c | c |
IVF, in vitro fertilization; NICU, neonatal intensive care unit.
a
Per 100,000 pregnancies
b
Vaginal births only
c
Insufficient data.
Luke et al. Risk of severe maternal morbidity. Am J Obstet Gynecol 2019.