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Hum. Reprod. Advance Access published online on May 25, 2006
Human Reproduction, doi:10.1093/humrep/del153
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received January 23, 2006
Revised March 8, 2006
Accepted April 7, 2006

Article

Increased risk of placenta previa in pregnancies following IVF/ICSI; a comparison of ART and non-ART pregnancies in the same mother

Liv Bente Romundstad 1 *, Pål R. Romundstad 2, Arne Sunde 3, Vidar von Düring 3, Rolv Skjærven 4, and Lars J. Vatten 2

1 Department of Obstetrics and Gynaecology, St Olavs University Hospital; Department of Public Health, Norwegian University of Science and Technology, Trondheim
2 Department of Public Health, Norwegian University of Science and Technology, Trondheim
3 Department of Obstetrics and Gynaecology, St Olavs University Hospital
4 The Medical Birth Registry of Norway; Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway

* To whom correspondence should be addressed.
Liv Bente Romundstad, E-mail: libero{at}ntnu.no


  Abstract

BACKGROUND: The risk of placenta previa may be increased in pregnancies conceived by assisted reproduction technology (ART). Whether the increased risk is due to factors related to the reproductive technology, or associated with maternal factors, is not known. METHODS: In a nationwide population-based study, we included 845 384 pregnancies reported to the Medical Birth Registry of Norway between 1988 and 2002 and compared the risk of placenta previa in 7568 pregnancies conceived after assisted fertilization, with the risk in naturally conceived pregnancies. To study the influence of ART more directly, we compared the risk of placenta previa between consecutive pregnancies among 1349 women who had conceived both naturally and after assisted fertilization. Odds ratios (OR), adjusted for maternal age, parity, previous Caesarean section and time interval between pregnancies were estimated using logistic regression. RESULTS: There was a six-fold higher risk of placenta previa in singleton pregnancies conceived by assisted fertilization compared with naturally conceived pregnancies [adjusted OR 5.6, 95% confidence interval (CI) 4.4-7.0]. Among mothers who had conceived both naturally and after assisted fertilization, the risk of placenta previa was nearly three-fold higher in the pregnancy following assisted fertilization (adjusted OR 2.9, 95% CI 1.4-6.1), compared with that in the naturally conceived pregnancy. CONCLUSIONS: The use of ART is associated with an increased risk of placenta previa. Our findings suggest that the increased risk may be caused by factors related to the reproductive technology.

Keywords: assisted reproduction technology/placenta previa/population study/sibling comparisons.
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