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Severe Maternal Morbidity, Mortality Up With Infertility Tx

Likelihood of having three or more severe maternal morbidity indicators greater with invasive infertility tx

pregnant woman exam

MONDAY, Feb. 4, 2019 (Pharmacist's Briefing) -- Women with infertility-treated pregnancy have an increased risk for severe maternal morbidity or maternal death, with invasive infertility treatment associated with an increased likelihood of having three or more severe maternal morbidity indicators, according to a study published online Feb. 4 in the CMAJ, the journal of the Canadian Medical Association.

Natalie Dayan, M.D., from the McGill University Health Centre in Montreal, and colleagues conducted a cohort study using population-based registries from 2006 to 2012. Using propensity score matching, based on demographic, reproductive, and obstetric factors, the authors compared pregnancies achieved using infertility treatment with unassisted pregnancies. Overall, 11,546 infertility treatment pregnancies were matched with 47,553 untreated pregnancies.

The researchers found that severe maternal morbidity or maternal death occurred in 356 and 1,054 infertility-treated and untreated pregnancies, respectively (30.8 versus 22.2 per 1,000 deliveries; relative risk, 1.39). Women who received invasive infertility treatment (odds ratio, 2.28; 95 percent confidence interval, 1.56 to 3.33) but not those who received noninvasive treatment (odds ratio, 0.99; 95 percent confidence interval, 0.57 to 1.72), had an increased likelihood of having three or more severe maternal morbidity indicators.

"Studies comparing invasive with less invasive infertility treatment should extend their focus beyond rates of live births to encompass maternal health outcomes," the authors write.

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