The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #68003

Cynthia Ferre, MPH, Division of Reproductive Health, Centers for Disease Control & Prevention, 4770 Buford Highway, K-23, Atlanta, GA 30341, 770-488-6268, cdf1@cdc.gov and Laura Schieve, Division of Reproductive Health, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS K-34, Atlanta, GA 30341.

ART is an important contributor to the U.S. low birth weight (LBW) rate. Previous analyses have not considered the impact of maternal race/ethnicity or entry into prenatal care on ART outcomes. To assess these issues, we examined data on singleton infants conceived through ART in 1999-2000, and recorded in the CDC-SART Registry, to further describe the relationship between ART, low birth weight (LBW, <2500 grams), and preterm delivery (PTD, <37 weeks gestation). Infants from the 2000 U.S. live birth population were the referent population. Analyses were restricted to infants whose mothers were between ages 20-44. To have similar gestational age estimates, we restricted the referent population to infants with gestational age determined by last menstrual period (LMP). In the ART population, gestational age was calculated from dates of oocyte retrieval or embryo transfer and of infant birth and then adjusted for LMP by adding 2 weeks. To have similar assessment of the effect of prenatal care, we restricted the referent population to those with care in the first trimester. Standardized risk ratios (RR) of observed to expected outcomes, adjusted for maternal age, parity, and race/ethnicity, and 95% CI were calculated. The adjusted RR were 1.6 (1.5-1.7) for LBW and 1.4 (1.3-1.5) for PTD. The results were also significant for both preterm and term LBW. These data indicate that ART accounts for a disproportionate number of both LBW and PTD infants in the U.S., independent of the effect of maternal age, parity, race/ethnicity and timing of prenatal care.

Learning Objectives:

At the conclusion of this session, the participant (learner) will be able to:
• Describe the observed relationship between ART, low birth weight, and prematurity.
• Discuss methodologic limitations in assessing the relationship between ART and pregnancy outcomes.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.