Ovulation induction/intrauterine insemination in infertile couples is associated with low-birth-weight infants.

OBJECTIVE The study was undertaken to determine the outcome of singleton pregnancies conceived through ovulation induction and intrauterine insemination using a partner's (OI/IUI) or donor sperm (OI/IUID) by comparison with naturally conceived singletons within a national cohort. STUDY DESIGN Retrospective cohort study in primigravid women who were treated with OI/IUI (n = 97) or OI/IUID (n = 35) at Glasgow Royal Infirmary between March 1993 and March 1997 and identified within the Scottish national cohort (n = 109,443) delivering during the same period. Univariate and multivariate logistic regression models were used to examine outcomes and to determine the factors associated with infertility treatment and low birth weight. RESULTS OI/IUI singletons were more likely to be lighter, of clinically low birth weight, and born more prematurely than natural conceptions. After adjustment for associated factors, these infants were 4.85 times (95% CI 2.25-10.48) more likely to be of low birth weight. We could not demonstrate any differences between OI/IUID and natural conceptions. CONCLUSION The perinatal outcome of singletons born to subfertile mothers conceived through OI/IUI is poorer than that of matched natural conceptions. We suggest that intrinsic factors in subfertile couples predispose them to having smaller infants and that "infertility" should be added to the list of recognized factors associated with low birth weight.

[1]  J. Meulen Glucose tolerance in adults after prenatal exposure to famine , 2001, The Lancet.

[2]  Roger Robinson,et al.  The fetal origins of adult disease , 2001, BMJ : British Medical Journal.

[3]  T P Fleming,et al.  Maternal undernutrition during the preimplantation period of rat development causes blastocyst abnormalities and programming of postnatal hypertension. , 2000, Development.

[4]  A. Ericson,et al.  Deliveries and children born after in-vitro fertilisation in Sweden 1982–95: a retrospective cohort study , 1999, The Lancet.

[5]  A. Venn,et al.  Perinatal and obstetric outcomes of donor insemination using cryopreserved semen in Victoria, Australia. , 1999, Human reproduction.

[6]  D. Barker Early growth and cardiovascular disease , 1999, Archives of disease in childhood.

[7]  S. Cnattingius,et al.  Preterm and term births of small for gestational age infants: a population‐based study of risk factors among nulliparous women , 1998, British journal of obstetrics and gynaecology.

[8]  H. Wollmann Intrauterine Growth Restriction: Definition and Etiology , 1998, Hormone Research in Paediatrics.

[9]  J. Murphy,et al.  Comparison of liveborn and stillborn low birthweight babies and analysis of aetiological factors. , 1997, Irish medical journal.

[10]  D. Barker,et al.  Fetal growth, length of gestation, and polycystic ovaries in adult life , 1997, The Lancet.

[11]  C Osmond,et al.  Mother's weight in pregnancy and coronary heart disease in a cohort of finnish men: follow up study , 1997, BMJ.

[12]  P J Hannan,et al.  Maternal Waist‐to-Hip Ratio as a Predictor of Newborn Size: Results of the Diana Project , 1996, Epidemiology.

[13]  B. Vohr,et al.  Maternal and neonatal morbidity associated with in vitro fertilization. , 1995, The Journal of pediatrics.

[14]  A. Andersen,et al.  Perinatal outcome after in vitro fertilisation , 1995, Acta obstetricia et gynecologica Scandinavica.

[15]  V. Carstairs,et al.  Deprivation and health in Scotland. , 1990, Health bulletin.

[16]  C. Matthews,et al.  The obstetric outcome of singleton pregnancies following in-vitro fertilization/gamete intra-fallopian transfer. , 1994, Human reproduction.