eprintid: 10138177 rev_number: 23 eprint_status: archive userid: 608 dir: disk0/10/13/81/77 datestamp: 2021-11-12 14:13:11 lastmod: 2022-07-05 14:03:01 status_changed: 2021-11-12 14:13:11 type: article metadata_visibility: show creators_name: Pelikh, A creators_name: Smith, K creators_name: Myrskylä, M creators_name: Goisis, A title: Medically Assisted Reproduction Treatment Types and Birth Outcomes: A Between- and Within-Family Analysis ispublished: pub divisions: UCL divisions: B16 divisions: B14 divisions: J81 divisions: K27 note: This is an Open Access article published under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) Licence (https://creativecommons.org/licenses/by-nc-nd/4.0/). abstract: OBJECTIVE: To compare risks of adverse birth outcomes among pregnancies conceived with and without medically assisted reproduction treatments. METHODS: Birth certificates were used to study birth outcomes of all neonates born in Utah from 2009 through 2017. Of the 469,919 deliveries, 52.8% (N=248,013) were included in the sample, with 5.2% of the neonates conceived through medically assisted reproduction. The outcome measures included birth weight, gestational age, low birth weight (LBW, less than 2,500 g), preterm birth (less than 37 weeks of gestation), and small for gestational age (SGA, birth weight less than the 10th percentile). Linear models were estimated for the continuous outcomes (birth weight, gestational age), and linear probability models were used for the binary outcomes (LBW, preterm birth, SGA). First, we compared the birth outcomes of neonates born after medically assisted reproduction and natural conception in the overall sample (between-family analyses), before and after adjustment for parental background and neonatal characteristics. Second, we employed family fixed effect models to investigate whether the birth outcomes of neonates conceived through medically assisted reproduction differed from those of their naturally conceived siblings (within-family comparisons). RESULTS: Neonates conceived through medically assisted reproduction weighed less, were born earlier, and were more likely to be LBW, preterm, and SGA than neonates conceived naturally. More invasive treatments (assisted reproductive technology [ART] and artificial insemination [AI] or intrauterine insemination) were associated with worse birth outcomes; for example, the proportion of LBW and preterm birth was 6.1% and 7.9% among neonates conceived naturally and 25.5% and 29.8% among neonates conceived through ART, respectively. After adjustments for various neonatal and parental characteristics, the differences in birth outcomes between neonates conceived through medically assisted reproduction and naturally were attenuated yet remained statistically significant; for example, neonates conceived through ART were at 3.2 percentage points higher risk for LBW (95% CI 2.4–4.1) and 4.8 percentage points higher risk for preterm birth (95% CI 3.9–5.7). Among siblings, the differences in the frequency of adverse outcomes between neonates conceived through medically assisted reproduction and neonates conceived naturally were small and statistically insignificant for all types of treatments. CONCLUSION: Medically assisted reproduction treatments are associated with adverse birth outcomes; however, those risks are unlikely to be associated with the infertility treatments itself. date: 2022-02 date_type: published publisher: Lippincott, Williams & Wilkins official_url: https://doi.org/10.1097/AOG.0000000000004655 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1898829 doi: 10.1097/AOG.0000000000004655 lyricists_name: Goisis, Alice lyricists_name: Pelikh, Alina lyricists_id: AGOIS69 lyricists_id: APELI39 actors_name: Stacey, Thomas actors_id: TSSTA20 actors_role: owner full_text_status: public publication: Obstetrics & Gynecology volume: 139 number: 2 pagerange: 211-222 citation: Pelikh, A; Smith, K; Myrskylä, M; Goisis, A; (2022) Medically Assisted Reproduction Treatment Types and Birth Outcomes: A Between- and Within-Family Analysis. Obstetrics & Gynecology , 139 (2) pp. 211-222. 10.1097/AOG.0000000000004655 <https://doi.org/10.1097/AOG.0000000000004655>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10138177/10/Pelikh_Medically_Assisted_Reproduction_Treatment_Types.9.pdf