Neonatal outcomes from in vitro fertilization-conceived pregnancies

  • Ashfahani Imanadhia Rumah Sakit Ibu dan Anak Bunda (Bunda Women’s and Children’s Hospital), Jakarta
  • Risma Kerina Kaban Rumah Sakit Ibu dan Anak Bunda (Bunda Women’s and Children’s Hospital), Jakarta
  • Adhi Teguh Perma Iskandar Rumah Sakit Ibu dan Anak Bunda (Bunda Women’s and Children’s Hospital), Jakarta
  • Reynaldo Rahima Putra Rumah Sakit Ibu dan Anak Bunda (Bunda Women’s and Children’s Hospital), Jakarta
  • Ressa Hana Natasa Rumah Sakit Ibu dan Anak Bunda (Bunda Women’s and Children’s Hospital), Jakarta
Keywords: Neonates, In vitro fertilization, Outcomes, Multiple pregnancies, Preterm births, Low birth weights

Abstract

Background In vitro fertilization (IVF) shows potential to improve pregnancy success, especially for infertile couples. This technique has some risks for neonates in the perinatal period and may affect their future health.

Objective To investigate the characteristics and clinical outcomes of neonates from IVF-conceived pregnancies.

Methods This retrospective study was conducted in neonates from IVF-conceived pregnancies from January to December 2021 at Bunda Women’s and Children’s Hospital, Jakarta. We gathered data from medical records about maternal age and morbidity, gravidity, gestational age, method of delivery, multiple gestation, also neonates’ significant profiles like prematurity, birth weight, Apgar score, and morbidities in perinatal period. We would like to investigate the characteristics and clinical outcomes of neonates born from IVF-conceived pregnancies program.

Results There were 361 neonates whose mothers underwent IVF included in this study. Most mothers were ?35 years (70.9%) and on their first pregnancy (69.2%). Maternal complicating factors were premature contractions (16.6%), premature rupture of membranes (8.3%), and twin pregnancy (31.5%). About 98.6% of deliveries were performed by caesarean section and from IVF-conceived pregnancies program most 61.2% neonates were born at full term gestation (61.2%). Preterm deliveries occurred at a mean gestational age of 34.4 (SD 2.4) weeks. Subjects’ mean birth weight was 2,800.2 (SD 640.3) grams, with 26.3% in the low-birth-weight category. Most neonates (93.0%) were appropriate weight for gestational age and had good Apgar scores in the first minute (92.2%) and fifth minute (99.7%). However, 24.3% of neonates needed intensive care (NICU) with morbidities. The longest length of NICU stay was 100 days, with mortality of 7.9% of NICU-treated infants.

Conclusion In our setting, most neonates from the IVF program were born with good outcomes, although preterm birth rate, low birth weight, need for NICU care, and mortality rate were quite high. Further study is needed to evaluate long-term outcomes of IVF neonates.

Author Biographies

Risma Kerina Kaban, Rumah Sakit Ibu dan Anak Bunda (Bunda Women’s and Children’s Hospital), Jakarta

Neonatologist from Bunda Women and Children Hospital Jakarta

Adhi Teguh Perma Iskandar, Rumah Sakit Ibu dan Anak Bunda (Bunda Women’s and Children’s Hospital), Jakarta

Neonatologist from Bunda Women and Children Hospital Jakarta

Reynaldo Rahima Putra, Rumah Sakit Ibu dan Anak Bunda (Bunda Women’s and Children’s Hospital), Jakarta

General practitioner in Bunda Women and Children Hospital Jakarta

Ressa Hana Natasa, Rumah Sakit Ibu dan Anak Bunda (Bunda Women’s and Children’s Hospital), Jakarta

General practitioner in Bunda Women and Children Hospital Jakarta

References

1. Sullivan-Pyke CS, Senapati S, Mainigi MA BK. In Vitro Fertilization and Adverse Obstetric and Per-inatal Outcomes. Semin Perinatol. 2017;176(12):345–53. DOI: https://doi.org/10.1053/j.semperi.2017.07.001.
2. Al-Hathlol K. Relationship between in Vitro Fertilization and Neonatal Outcomes in Very Low Birth Weight Preterm Infants. Am J Perinatol. 2018;35(11):1113–8. DOI: https://doi.org/10.1055/s-0038-1641590.
3. Egbe TO, Sandjon G, Ourtchingh C, Simo A, Priso EB, Benifla J-L. In-vitro fertilization and sponta-neous pregnancies: matching outcomes in Douala, Cameroon. Fertil Res Pract. 2016;2(1):1–8. DOI: https://doi.org/10.1186/s40738-015-0013-2.
4. Buchori M, Patria SY, Wibowo T, Hanoum IF. Neonatal outcomes in in vitro fertilization (IVF) pregnancies. J thee Med Sci (Berkala Ilmu Kedokteran). 2018;50(2). DOI: https://doi.org/10.19106/jmedsci005002201805.
5. Prevention C for DC and. Assisted Reproductive Technology Surveillance. Morb Mortal Wkly Rep [Internet]. 2018 [cited 2019 Dec 28];67(3). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5829941/pdf/ss6703a1.pdf
6. Ahmad KA, Bennett MM, Rayburn P, Combs CA, Clark RH, Tolia VN. Outcomes of preterm in-fants conceived with in vitro fertilization. J Perinatol. 2019;39(5):717–22. DOI: https://doi.org/10.1038/s41372-019-0332-y.
7. Turker G, Doger E, Arsoy AE, Günlemez A, Gökalp AS. The effect of IVF pregnancies on mortality and morbidity in tertiary unit. Ital J Pediatr. 2013;39(1):1–7. DOI: https://doi.org/10.1186/1824-7288-39-17.
8. Sabban H, Zakhari A, Patenaude V, Tulandi T, Abenhaim HA. Obstetrical and perinatal morbidity and mortality among in-vitro fertilization pregnancies: a population-based study. Arch Gynecol Obstet. 2017;296(1):107–13. DOI: https://doi.org/10.1007/s00404-017-4379-8.
9. Corchia C, Da Frè M, Di Lallo D, Gagliardi L, Macagno F, Carnielli V, et al. Mortality and major morbidities in very preterm infants born from assisted conception or naturally conceived: Results of the area-based ACTION study. BMC Pregnancy Childbirth. 2014;14(1):1–8. DOI: https://doi.org/10.1186/1471-2393-14-307.
10. World Health Organization. Preterm Birth [serial on the Internet]. 2022 [cited 2022, April 25]. Available from: https://www.who.int/news-room/fact-sheets/detail/preterm-birth
11. Organization WH. International statistical classification of diseases and related health problems, tenth revision, 2nd ed [Internet]. World Health Organization. 2004 [cited 2021, Dec 20];95. Available from: https://www. https://apps.who.int/iris/handle/10665/42980.
12. Lubchenco LO, Hansman C, Dressler M, Boyd E. Intrauterine growth as estimated. Pediatrics. 1963;32(5):793–800. PMID: 14075621.
13. Sweet DG, Carnielli VP, Greisen G, Hallman M, Ozek E, Pas A, et al. European Consensus Guide-lines on the Management of Respiratory Distress Syndrome?: 2022 Update. 2023;3–23. DOI: https://doi.org/10.1159/000528914.
14. Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intra-ventricular hemorrhage: A study of infants with birth weights less than 1,500 gm. J Pediatr. 1978;92(4):529–34. DOI: https://doi.org/10.1016/S0022-3476(78)80282-0.
15. Bowerman RA, Donn SM, Silver TM, Jaffe MH. Natural History of Neonatal Periventricular/ Intra-ventricular Hemorrhage and Its Complications: Sonographic Observations. AJR Am J Roentgenol. 1984;143(5):1041–52. DOI: https://doi.org/10.2214/ajr.143.5.1041.
16. BELL MJ, TERNBERG JL, FEIGIN RD, KEATING JP, MARSHALL R, BARTON L, et al. Neonatal Ne-crotizing Enterocolitis. Therapeutic Decisions Based Upon Clinical Staging. Ann Surg. 1978;187(1):1–7. DOI: https://doi.org/10.1097/00000658-197801000-00001.
17. Chiang MF, Quinn GE, Fielder AR, Ostmo SR, Paul Chan R V., Berrocal A, et al. International Clas-sification of Retinopathy of Prematurity, Third Edition. Ophthalmology. 2021;128(10):e51–68. DOI: https://doi.org/10.1016/j.ophtha.2021.05.031.
18. Narayan S, Rana KS, Sharma M, Sharma RK, Talwar P, Kapur K, et al. Profile of live-born infants of in-vitro fertilisation. Med J Armed Forces India. 2010;66(1):18–21. DOI: https://doi.org/10.1016/S0377-1237(10)80085-1.
19. Wiweko B. Characteristic and Pregnancy Rate of IVF Patient: a Retrospective Analysis from Two Centres. KnE Med. 2016;1(1):43–8. DOI: https://doi.org/10.18502/kme.v1i1.535.
20. Indarwati I, Budihastuti UR, Dewi YLR. Analysis of Factors Influencing Female Infertility. J Matern Child Heal. 2017;02(02):150–61. DOI: https://doi.org/10.26911/thejmch.2017.02.02.06.
21. Kemenkes RI. Riset Kesehatan Dasar; Badan Penelitian dan Pengembangan Kesehatan Kemen-terian Kesehatan RI Tahun 2010. Lap Nas 2010 [Internet]. 2010 [cited 2021, Dec 19];1–446. Available from: http://labdata.litbang.kemkes.go.id/?hal=riskesdas&id=2010.
22. Gupta P, Nayan N, Sharma M. Perinatal outcomes among children born by assisted reproductive techniques-a hospital-based case control study. Med J Armed Forces India. 2012;68(2):132–5. DOI: https://doi.org/10.1016/S0377-1237(12)60019-7.
23. Sini I, Handayani N, Pratiwi A, Polim A, Boediono A. Blastocyst elective single embryo transfer improves perinatal outcomes among women undergoing assisted reproductive technology in Indonesia. Asian Pacific J Reprod. 2020;9(3):118–23. DOI: https://doi.org/10.4103/2305-0500.284268.
24. Pandey S, Shetty A, Hamilton M, Bhattacharya S, Maheshwari A. Obstetric and perinatal out-comes in singleton pregnancies resulting from ivf/icsi: A systematic review and meta-analysis. Hum Re-prod Update. 2012;18(5):485–503. DOI: https://doi.org/10.1093/humupd/dms018.
25. Qin J, Sheng X, Wu D, Gao S, You Y, Yang T, et al. Adverse obstetric outcomes associated with in vitro fertilization in singleton pregnancies: A prospective cohort study. Reprod Sci. 2017;24(4):595–608. DOI: https://doi.org/10.1177/1933719116667229.
26. Mansour R, Ishihara O, Adamson GD, Dyer S, De Mouzon J, Nygren KG, et al. International committee for monitoring assisted reproductive technologies world report: Assisted reproductive tech-nology 2006. Hum Reprod. 2014;29(7):1536–51. DOI: https://doi.org/10.1093/humrep/deu084.
27. Szymusik I, Kosinska-Kaczynska K, Krowicka M, Sep M, Marianowski P, Wielgos M. Perinatal outcome of in vitro fertilization singletons – 10 years’ experience of one center. Arch Med Sci. 2019;15(3):666–72. DOI: https://doi.org/10.5114/aoms.2019.82670.
28. Valvi D, Swaminathan G. Maternal and perinatal outcome following assisted reproductive tech-nology in a tertiary care centre: a retrospective study. Int J Reprod Contraception, Obstet Gynecol. 2019;8(5):1745. DOI: https://doi.org/10.18203/2320-1770.ijrcog20191529.
29. Watterberg KL, Aucott S, Benitz WE, Cummings JJ, Eichenwald EC, Goldsmith J, et al. The apgar score. Pediatrics. 2015;136(4):819–22. DOI: https://doi.org/10.1542/peds.2015-2651.
Published
2023-07-31
How to Cite
1.
Imanadhia A, Kaban R, Iskandar A, Putra R, Natasa R. Neonatal outcomes from in vitro fertilization-conceived pregnancies. PI [Internet]. 31Jul.2023 [cited 14May2024];63(4):238-4. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/3007
Section
Neonatology
Received 2022-03-27
Accepted 2023-07-31
Published 2023-07-31