Human Reproduction, Vol. 17, No. 11, 2897-2903,
November 2002
© 2002 European Society of Human Reproduction and Embryology
The course of pregnancy and delivery and the use of maternal healthcare services after standard IVF in Northern Finland 1990–1995
1 Department of Public Health Science and General Practice, University of Oulu, P.O.Box 5000, 90014 Oulu, 2 Department of Obstetrics and Gynecology, University Hospital of Oulu, P.O.Box 24, 90029 Oulu, 3 The Family Federation of Finland, Kiviharjuntie 11, 90220 Oulu, 4 National Research and Development Center for Welfare and Health, P.O.Box 220, 00531 Helsinki, Finland and 5 Department of Epidemiology and Public Health, Imperial College School of Medicine, London, UK
BACKGROUND: The objective of this study was to evaluate the course of pregnancy and delivery and the use of maternal healthcare after IVF. METHODS: This population-based cohort study included all women who had undergone IVF treatment in Northern Finland leading to delivery in 1990–1995 (n = 225) and control pregnancies derived from the Finnish Medical Birth Register (n = 671) matched for sex of the child, year of birth, area, maternal age, parity, social class and fetal plurality. The analyses were stratified by plurality. Outcome measures were pregnancy complications, mode of delivery, gestational length and the level of use of antenatal care. RESULTS: The results showed an increased risk for vaginal bleeding throughout pregnancy [relative risk (RR) 4.1, 95% confidence interval (CI) 2.5–6.7 for singletons; RR 6.9, 95% CI 2.5–19.2 for twins], threatened preterm birth (RR 1.8, 95% CI 1.1–2.9, singletons) and intrahepatic cholestasis of pregnancy (RR 3.8, 95% CI 1.0–15.0, singletons) in IVF pregnancies, as well as an increase in the use of specialized antenatal care. CONCLUSIONS: IVF pregnancies following standard, fresh ova IVF treatments are at greater risk of obstetric problems than spontaneously conceived pregnancies, and hence IVF mothers use more specialized antenatal care than others. The pregnancy complications after IVF are likely to be due to maternal characteristics regarding infertility and to a high incidence of multiple pregnancies.
Key words: delivery/healthcare services/IVF/pregnancy complications
6 To whom correspondence should be addressed at: Department of Obstetrics and Gynecology, University Hospital of Oulu, P.O.Box 24, 90029 Oulu, Finland. E-mail: sari.koivurova{at}oulu.fi
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