Intrapartum interventions for singleton pregnancies arising from assisted reproductive technologies

Area of Science:

• Reproductive Medicine
• Obstetrics
• Perinatal Epidemiology

Background:

• Assisted reproductive technology (ART) is increasingly used for conception.
• The impact of ART on intrapartum interventions requires further investigation.

Purpose of the Study:

• To compare intrapartum intervention rates in singleton pregnancies conceived by ART versus spontaneous conception.
• To analyze indications for Cesarean sections in ART versus spontaneous singleton pregnancies.

Main Methods:

• Retrospective cohort study using the Better Outcomes Registry and Network (BORN) Ontario database (2004-2008).
• Inclusion of 1327 ART and 5222 spontaneous singleton pregnancies.
• Comparison of incidences of electronic fetal monitoring, artificial membrane rupture, oxytocin augmentation, labor induction, and Cesarean section.

Main Results:

• ART pregnancies had significantly higher rates of internal electronic fetal monitoring (OR 1.60), artificial rupture of membranes (OR 1.39), oxytocin augmentation (OR 1.51), labor induction (OR 1.31), and Cesarean section (OR 1.40) compared to spontaneous pregnancies.
• Analysis included different Cesarean section classification systems.

Conclusions:

• Singleton pregnancies conceived via ART are associated with increased utilization of various intrapartum interventions.
• Cesarean section rates are notably higher in ART-conceived singleton pregnancies.