Maternal and Perinatal Outcome in Pregnancies Following Infertility

Context: General practitioners as well as obstetricians are coming across a large number of pregnant women whose conceptions are following a period of infertility or treatment for the same. There is a controversy in the literature regarding the occurrence of adverse outcomes of pregnancy in such women. Aims: To assess the maternal and perinatal outcome in pregnancies that occurred after a period of infertility and to compare the outcome in spontaneous conceptions with the conceptions following treatment for infertility. Settings and Design: Retrospective analysis of hospital records of 200 pregnancies following infertility during the year 2009 in a tertiary care center in South India. Material and Methods: All the women were divided into two groups, viz: Group 1—those who had history of infertility but conceived spontaneously and Group 2—those with history of infertility and conceived only after treatment for infertility. The main outcome measures were antenatal complications and adverse neonatal complications. Statistical analysis: The statistical package SSPS version 15.0. Chi-square and student ‘t’ test was used for nonparametric and parametric variables. Results: The incidence of hypertension was 60% and that of gestational diabetes was 7%. Obstetric complications included increased incidence of preterm labor (23.5%) and premature rupture of membranes (38%). There was no statistically significant difference in both groups though the medical complications especially hypertension was high in the pregnancies following spontaneous conceptions, i.e. untreated group. There was a greater demand for the NICU care mainly because of prematurity. The PNMR was (40/1000) less than the institutional rate of 72/1000 births. Conclusions: There is increased incidence of hypertension premature rupture of membranes and preterm delivery in pregnancies following infertility. There is no significant statistical difference in the adverse pregnancy outcomes between spontaneous conception and those treated for infertility. Key Messages: Pregnancies following infertility are at increased risk of developing hypertension and preterm labor and hence these women should be screened for the same and preventive measures to be undertaken to achieve good maternal and perinatal outcome.