Extremities of body mass index and their association with pregnancy outcomes in women undergoing in vitro fertilization in the United States
Objective To investigate the associations among underweight body mass index (BMI), pregnancy, and obstetric outcomes among women using assisted reproductive technology (ART). Design Retrospective cohort study using national data and log binomial regression. Setting Not applicable. Patient(s) Women u...
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Published in | Fertility and sterility Vol. 106; no. 7; pp. 1742 - 1750 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
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United States
Elsevier Inc
01.12.2016
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Abstract | Objective To investigate the associations among underweight body mass index (BMI), pregnancy, and obstetric outcomes among women using assisted reproductive technology (ART). Design Retrospective cohort study using national data and log binomial regression. Setting Not applicable. Patient(s) Women undergoing IVF in the United States from 2008 to 2013. Intervention(s) None. Main Outcome Measure(s) Pregnancy outcomes (intrauterine pregnancy, live birth rates) per transfer, miscarriage rate per pregnancy, and low birth weight and preterm delivery rates among singleton and twin pregnancies. Result(s) For all fresh autologous in vitro fertilization (IVF) cycles in the United States from 2008 to 2013 (n = 494,097 cycles, n = 402,742 transfers, n = 180,855 pregnancies) reported to the national ART Surveillance System, compared with normal weight women, underweight women had a statistically significant decreased chance of intrauterine pregnancy (adjusted risk ratio [aRR] 0.97; 95% confidence interval [CI], 0.96–0.99) and live birth (aRR 0.95; 95% CI, 0.93–0.98) per transfer. Obese women also had a statistically decreased likelihood of both (aRR 0.94; 95% CI, 0.94–0.95; aRR 0.87; 95% CI, 0.86–0.88, respectively). Among cycles resulting in singleton pregnancy, both underweight and obese statuses were associated with increased risk of low birth weight (aRR 1.39; 95% CI, 1.25–1.54, aRR 1.26; 95% CI, 1.20–1.33, respectively) and preterm delivery (aRR 1.12; 95% CI, 1.01–1.23, aRR 1.42; 95% CI, 1.36–1.48, respectively). The association between underweight status and miscarriage was not statistically significant (aRR 1.04; 95% CI, 0.98–1.11). In contrast, obesity was associated with a statistically significantly increased miscarriage risk (aRR 1.23; 95% CI, 1.20–1.26). Conclusion(s) Among women undergoing IVF, prepregnancy BMI affects pregnancy and obstetric outcomes. Underweight status may have a limited impact on pregnancy and live-birth rates, but it is associated with increased preterm and low-birth-weight delivery risk. Obesity negatively impacts all ART and obstetric outcomes investigated. |
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AbstractList | Objective To investigate the associations among underweight body mass index (BMI), pregnancy, and obstetric outcomes among women using assisted reproductive technology (ART). Design Retrospective cohort study using national data and log binomial regression. Setting Not applicable. Patient(s) Women undergoing IVF in the United States from 2008 to 2013. Intervention(s) None. Main Outcome Measure(s) Pregnancy outcomes (intrauterine pregnancy, live birth rates) per transfer, miscarriage rate per pregnancy, and low birth weight and preterm delivery rates among singleton and twin pregnancies. Result(s) For all fresh autologous in vitro fertilization (IVF) cycles in the United States from 2008 to 2013 (n = 494,097 cycles, n = 402,742 transfers, n = 180,855 pregnancies) reported to the national ART Surveillance System, compared with normal weight women, underweight women had a statistically significant decreased chance of intrauterine pregnancy (adjusted risk ratio [aRR] 0.97; 95% confidence interval [CI], 0.96–0.99) and live birth (aRR 0.95; 95% CI, 0.93–0.98) per transfer. Obese women also had a statistically decreased likelihood of both (aRR 0.94; 95% CI, 0.94–0.95; aRR 0.87; 95% CI, 0.86–0.88, respectively). Among cycles resulting in singleton pregnancy, both underweight and obese statuses were associated with increased risk of low birth weight (aRR 1.39; 95% CI, 1.25–1.54, aRR 1.26; 95% CI, 1.20–1.33, respectively) and preterm delivery (aRR 1.12; 95% CI, 1.01–1.23, aRR 1.42; 95% CI, 1.36–1.48, respectively). The association between underweight status and miscarriage was not statistically significant (aRR 1.04; 95% CI, 0.98–1.11). In contrast, obesity was associated with a statistically significantly increased miscarriage risk (aRR 1.23; 95% CI, 1.20–1.26). Conclusion(s) Among women undergoing IVF, prepregnancy BMI affects pregnancy and obstetric outcomes. Underweight status may have a limited impact on pregnancy and live-birth rates, but it is associated with increased preterm and low-birth-weight delivery risk. Obesity negatively impacts all ART and obstetric outcomes investigated. OBJECTIVETo investigate the associations among underweight body mass index (BMI), pregnancy, and obstetric outcomes among women using assisted reproductive technology (ART).DESIGNRetrospective cohort study using national data and log binomial regression.SETTINGNot applicable.PATIENT(S)Women undergoing IVF in the United States from 2008 to 2013.INTERVENTION(S)None.MAIN OUTCOME MEASURE(S)Pregnancy outcomes (intrauterine pregnancy, live birth rates) per transfer, miscarriage rate per pregnancy, and low birth weight and preterm delivery rates among singleton and twin pregnancies.RESULT(S)For all fresh autologous in vitro fertilization (IVF) cycles in the United States from 2008 to 2013 (n = 494,097 cycles, n = 402,742 transfers, n = 180,855 pregnancies) reported to the national ART Surveillance System, compared with normal weight women, underweight women had a statistically significant decreased chance of intrauterine pregnancy (adjusted risk ratio [aRR] 0.97; 95% confidence interval [CI], 0.96-0.99) and live birth (aRR 0.95; 95% CI, 0.93-0.98) per transfer. Obese women also had a statistically decreased likelihood of both (aRR 0.94; 95% CI, 0.94-0.95; aRR 0.87; 95% CI, 0.86-0.88, respectively). Among cycles resulting in singleton pregnancy, both underweight and obese statuses were associated with increased risk of low birth weight (aRR 1.39; 95% CI, 1.25-1.54, aRR 1.26; 95% CI, 1.20-1.33, respectively) and preterm delivery (aRR 1.12; 95% CI, 1.01-1.23, aRR 1.42; 95% CI, 1.36-1.48, respectively). The association between underweight status and miscarriage was not statistically significant (aRR 1.04; 95% CI, 0.98-1.11). In contrast, obesity was associated with a statistically significantly increased miscarriage risk (aRR 1.23; 95% CI, 1.20-1.26).CONCLUSION(S)Among women undergoing IVF, prepregnancy BMI affects pregnancy and obstetric outcomes. Underweight status may have a limited impact on pregnancy and live-birth rates, but it is associated with increased preterm and low-birth-weight delivery risk. Obesity negatively impacts all ART and obstetric outcomes investigated. To investigate the associations among underweight body mass index (BMI), pregnancy, and obstetric outcomes among women using assisted reproductive technology (ART). Retrospective cohort study using national data and log binomial regression. Not applicable. Women undergoing IVF in the United States from 2008 to 2013. None. Pregnancy outcomes (intrauterine pregnancy, live birth rates) per transfer, miscarriage rate per pregnancy, and low birth weight and preterm delivery rates among singleton and twin pregnancies. For all fresh autologous in vitro fertilization (IVF) cycles in the United States from 2008 to 2013 (n = 494,097 cycles, n = 402,742 transfers, n = 180,855 pregnancies) reported to the national ART Surveillance System, compared with normal weight women, underweight women had a statistically significant decreased chance of intrauterine pregnancy (adjusted risk ratio [aRR] 0.97; 95% confidence interval [CI], 0.96-0.99) and live birth (aRR 0.95; 95% CI, 0.93-0.98) per transfer. Obese women also had a statistically decreased likelihood of both (aRR 0.94; 95% CI, 0.94-0.95; aRR 0.87; 95% CI, 0.86-0.88, respectively). Among cycles resulting in singleton pregnancy, both underweight and obese statuses were associated with increased risk of low birth weight (aRR 1.39; 95% CI, 1.25-1.54, aRR 1.26; 95% CI, 1.20-1.33, respectively) and preterm delivery (aRR 1.12; 95% CI, 1.01-1.23, aRR 1.42; 95% CI, 1.36-1.48, respectively). The association between underweight status and miscarriage was not statistically significant (aRR 1.04; 95% CI, 0.98-1.11). In contrast, obesity was associated with a statistically significantly increased miscarriage risk (aRR 1.23; 95% CI, 1.20-1.26). Among women undergoing IVF, prepregnancy BMI affects pregnancy and obstetric outcomes. Underweight status may have a limited impact on pregnancy and live-birth rates, but it is associated with increased preterm and low-birth-weight delivery risk. Obesity negatively impacts all ART and obstetric outcomes investigated. |
Author | Hipp, Heather S., M.D Kulkarni, Aniket K., M.B.B.S., M.P.H Crawford, Sara, Ph.D Kawwass, Jennifer F., M.D Kissin, Dmitry M., M.D., M.P.H Jamieson, Denise J., M.D., M.P.H |
AuthorAffiliation | a Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, School of Medicine, Emory University b Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia |
AuthorAffiliation_xml | – name: a Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, School of Medicine, Emory University – name: b Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia |
Author_xml | – sequence: 1 fullname: Kawwass, Jennifer F., M.D – sequence: 2 fullname: Kulkarni, Aniket K., M.B.B.S., M.P.H – sequence: 3 fullname: Hipp, Heather S., M.D – sequence: 4 fullname: Crawford, Sara, Ph.D – sequence: 5 fullname: Kissin, Dmitry M., M.D., M.P.H – sequence: 6 fullname: Jamieson, Denise J., M.D., M.P.H |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/27666564$$D View this record in MEDLINE/PubMed |
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Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Reprint requests: Jennifer Fay Kawwass, M.D., Reproductive Endocrinology and Infertility Assistant Professor, Department of Gynecology and Obstetrics, Emory University School of Medicine, Guest Researcher, Centers for Disease Control and Prevention, 550 Peachtree Street, Suite 1800, Atlanta, Georgia 30308 (jennifer.kawwass@emory.edu). |
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Snippet | Objective To investigate the associations among underweight body mass index (BMI), pregnancy, and obstetric outcomes among women using assisted reproductive... To investigate the associations among underweight body mass index (BMI), pregnancy, and obstetric outcomes among women using assisted reproductive technology... OBJECTIVETo investigate the associations among underweight body mass index (BMI), pregnancy, and obstetric outcomes among women using assisted reproductive... |
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SubjectTerms | Abortion, Spontaneous - etiology Adult Birth Weight Body Mass Index Databases, Factual Female Fertility Fertilization in Vitro - adverse effects Gestational Age Humans Infant, Low Birth Weight Infertility - diagnosis Infertility - physiopathology Infertility - therapy Internal Medicine IVF Live Birth miscarriage Obesity - complications Obesity - diagnosis Obesity - physiopathology Obstetrics and Gynecology Odds Ratio outcomes Pregnancy Pregnancy Rate Pregnancy, Twin Premature Birth - etiology preterm Retrospective Studies Risk Factors Thinness - complications Thinness - diagnosis Thinness - physiopathology Time Factors Treatment Outcome underweight United States |
Title | Extremities of body mass index and their association with pregnancy outcomes in women undergoing in vitro fertilization in the United States |
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