Stillbirth Rates Are Low With Assisted Reproductive Technology

By Nancy A. Melville

AUSTIN, Tex -- May 3, 2018 -- Pregnancies that occur with the use of assisted reproductive technology (ART) are associated with significantly lower rates of stillbirth pregnancy, compared with conventional pregnancies, according to a study presented here at the 2018 Annual Meeting of the American College of Obstetricians and Gynecologists (ACOG).

Jeani Chang, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, and colleagues evaluated stillbirth trends using ART surveillance and vital records from Connecticut, Florida, Massachusetts, and Michigan, between 2006 and 2011.

In total, 282 stillbirths among ART pregnancies were identified and 15,540 stillbirths from conventional pregnancies.

The rates of stillbirths per 1,000 live births were only about half the rate both for singleton ART pregnancies (3.1) compared with non-ART pregnancies (6.0), and for multi-fetal pregnancies (9.4 vs 18.3, respectively).

In addition, the risk of stillbirth at <28 weeks was significantly lower for ART pregnancies compared with non-ART (singletons: adjusted risk ratio [aRR] = 0.38, 95% confidence interval [CI], 0.22-0.65; multiples: aRR = 0.63, 95% CI, 0.42-0.94).

There were no significant differences between ART and non-ART pregnancies in terms of the leading causes of stillbirth, which included maternal conditions (16.6%), such as hypertensive disorders, infections, respiratory diseases, periodontal diseases, or incompetent cervix; placental abnormalities (9.8%); umbilical cord conditions (9.2%); chorioamnionitis (3.8%); and low birth weight (2.7%).

Although ART procedures, including fresh donor oocytes and frozen embryos, are considered to be generally safe, some previous studies have shown adverse outcomes, including higher rates of stillbirths, as well as preterm birth and birth defects.

The authors speculated that the improved stillbirth rates associated with ART pregnancies in the current study may reflect the more intensified level of care that those pregnancies are given.

“Earlier detection and management of fetal and maternal conditions among ART-conceived
pregnancies may explain the lower rates of early fetal death observed in this study,” they said.

[Presentation title: Assisted Reproductive Technology and Stillbirth Risk: Selected States, 2006-2011. Abstract 15OP]
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