IMPACT OF INFERTILITY TREATMENTS ON THE HEALTH OF NEWBORNS

Objective: To measure the use of infertility treatments in the general population and their association with neonatal health. Design: Cross- sectional, population-based study. Setting: Canton of Vaud, Switzerlan d; Etude du Developpement des Nouveau-nes (EDEN), a prospective study of chronic childhood conditions. Patient(s): Six thousand four hundred seventy-seven live newborns(6,379 pregnancies) delivered of residents of Vaud in the 19 maternity hospitals between 1993 and 1994. Main Out come Measure(s): Neonatal morbidity, multiplicity, low birth weight, p rematurity, intrauterine growth retardation, transfer to intensive car e, and length of hospital stay. Result(s): Infertility treatments were reported for 2.1% of pregnancies (129 women, 148 newborns) and were a ssociated significantly with adverse outcomes. Population-attributable risks varied from 3%-20%. The outcomes of twins did not differ regard less of whether their mother was treated for infertility. Among single tons, only low birth weight was significantly more frequent when infer tility treatments were used. Unadjusted odds ratios for neonatal morbi dity were significant only for multiple births (2.56; 95% confidence i nterval 1.21-5.42). This association was not influenced by maternal ch aracteristics and it disappeared after controlling for sex, gestationa l age, and birth weight. Conclusion(s): An independent effect of infer tility treatments on neonatal morbidity cannot be ruled out, but most of their impact appeared to be mediated by multiplicity and prematurit y. Reducing the number of medically induced multiple pregnancies is th e most effective prevention of neonatal morbidity related to infertili ty treatments. Follow-up studies are needed. (C) 1998 by American Soci ety for Reproductive Medicine.