Preterm birth among pregnancies conceived by assisted reproduction techniques in Mumbai, Maharashtra, India

Authors

  • Anushree D. Patil Department of Clinical Research, ICMR-National Institute for Research in Reproductive Health, Mumbai, Maharashtra, India
  • Sanjay L. Chauhan Department of Clinical Research, ICMR-National Institute for Research in Reproductive Health, Mumbai, Maharashtra, India
  • Achhelal R. Pasi Department of Clinical Research, ICMR-National Institute for Research in Reproductive Health, Mumbai, Maharashtra, India
  • Rahul K. Gajbhiye Department of Clinical Research, ICMR-National Institute for Research in Reproductive Health, Mumbai, Maharashtra, India
  • Shalini Singh Department of Reproductive and Child Health, Indian Council of Medical Research (ICMR), New Delhi, India
  • Charu Sud Department of Clinical Research, ICMR-National Institute for Research in Reproductive Health, Mumbai, Maharashtra, India
  • Rana Khan Department of Clinical Research, ICMR-National Institute for Research in Reproductive Health, Mumbai, Maharashtra, India
  • Jatin S. Shah Director, Mumbai Fertility Clinic, Mumbai, Maharashtra, India
  • Duru S. Shah Director, Gynaec World Clinic, Mumbai, Maharashtra, India
  • Ameet S. Patki Consultant, Fertility Associates, Mumbai, Maharashtra, India
  • Nitin M. Narvekar Director, Narvekar Infertility and Endoscopy Clinic, Mumbai, Maharashtra, India
  • Sanjeev S. Khot Director, Orrchid Fertility Centre, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20181353

Keywords:

Assisted reproduction techniques, ART, Preterm birth

Abstract

Background: Preterm births are an enormous global problem on families, medical system and economy. The rates of preterm birth are increasing and one of the contributors is growing use of Assisted Reproduction Techniques (ART) leading to multifetal gestations. Some risk factors for preterm birth are specific to women who conceive by ART. Since there is limited data from India, this pilot study was undertaken to assess the magnitude of preterm birth among pregnancies conceived by ART and to study the contributing factors.

Methods: Clinic based descriptive cohort study through eight ART clinics in Mumbai for one year. Data was collected using an in-depth questionnaire on socio-demographic characteristics, medical history, ART details, course and complications during pregnancy, mode of delivery, pregnancy outcome, risk factors related to preterm birth and neonatal outcome. Complete details of 113 participants who completed the study were analyzed.

Results: Study showed high incidence of preterm birth (76.23%) among women conceived with ART. Multiple gestations were observed in 45.1%. Pregnancy related complications like heterotrophic pregnancy (3%), pre eclampsia (15%) and gestational diabetes (11%) were high. Incidence of caesarean section was very high (98%). Neonatal outcome was good with 98% live births and only 2 still births.

Conclusions: Present study highlights that preterm birth, multiple pregnancies, pregnancy related complications like preeclampsia, gestational diabetes and caesarean sections are very high among women conceived by ART. With growing use of ART there is an urgent need to develop a National ART Surveillance system in India like the one in Centre for Disease Control Atlanta to get complete data on the pregnancy course and outcomes of ART conceptions. Efforts to limit the number of embryos transferred should be strengthened to prevent multiple births.

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Published

2018-03-27

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Original Research Articles