Maternal age and risk of low birth weight and premature birth in children conceived through medically assisted reproduction : Evidence from Finnish population registers

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Barbuscia , A , Martikainen , P , Myrskylä , M , Remes , H , Somigliana , E , Klemetti , R & Goisis , A 2020 , ' Maternal age and risk of low birth weight and premature birth in children conceived through medically assisted reproduction : Evidence from Finnish population registers ' , Human Reproduction , vol. 35 , no. 1 , pp. 212–220 . https://doi.org/10.1093/humrep/dez275

Title: Maternal age and risk of low birth weight and premature birth in children conceived through medically assisted reproduction : Evidence from Finnish population registers
Author: Barbuscia, Anna; Martikainen, Pekka; Myrskylä, Mikko; Remes, Hanna; Somigliana, Edgardo; Klemetti, Reija; Goisis, Alice
Contributor organization: Helsinki Inequality Initiative (INEQ)
Population Research Unit (PRU)
Center for Population, Health and Society
Sociology
Centre for Social Data Science, CSDS
Demography
Date: 2020-01-01
Language: eng
Number of pages: 9
Belongs to series: Human Reproduction
ISSN: 0268-1161
DOI: https://doi.org/10.1093/humrep/dez275
URI: http://hdl.handle.net/10138/317217
Abstract: STUDY QUESTION Does the risk of low birth weight and premature birth increase with age among mothers who conceive through medically assisted reproduction (MAR)? SUMMARY ANSWER Among MAR mothers, the risk of poorer birth outcomes does not increase with maternal age at birth except at very advanced maternal ages (40+). WHAT IS KNOWN ALREADY The use of MAR treatments has been increasing over the last few decades and is especially diffused among women who conceive at older ages. Although advanced maternal age is a well-known risk factor for adverse birth outcomes in natural pregnancies, only a few studies have directly analysed the maternal age gradient in birth outcomes for MAR mothers. STUDY DESIGN, SIZE, DURATION The base dataset was a 20% random sample of households with at least one child aged 0-14 at the end of 2000, drawn from the Finnish population register and other administrative registers. This study included children who were born in 1995-2000, because the information on whether a child was conceived through MAR or naturally was available only from 1995 onwards. PARTICIPANTS/MATERIALS, SETTING, METHODS The outcome measures were whether the child had low birth weight (LBW, MAIN RESULTS AND THE ROLE OF CHANCE A total of 56026 children, 2624 of whom were conceived through MAR treatments, were included in the study. Among the mothers who used MAR to conceive, maternal age was not associated with an increased risk of LBW (the overall prevalence was 12.6%) at ages 25-39. For example, compared to the risk of LBW at ages 30-34, the risk was 0.22 percentage points lower (95% CI: -3.2, 2.8) at ages 25-29 and was 1.34 percentage points lower (95% CI: -4.5, 1.0) at ages 35-39. The risk of LBW was increased only at maternal ages >= 40 (six percentage points, 95% CI: 0.2, 12). Adjustment for maternal characteristics only marginally attenuated these associations. In contrast, among the mothers who conceived naturally, the results showed a clear age gradient. For example, compared to the risk of LBW (the overall prevalence was 3.3%) at maternal ages 30-34, the risk was 1.1 percentage points higher (95% CI: 0.6, 1.6) at ages 35-39 and was 1.5 percentage points higher (95% CI: 0.5, 2.6) at ages >= 40. The results were similar for preterm births. LIMITATIONS, REASON FOR CAUTION A limited number of confounders were included in the study because of the administrative nature of the data used. Our ability to reliably distinguish mothers based on MAR treatment type was also limited. WIDER IMPLICATIONS OF THE FINDINGS This is the first study to analyse the maternal age gradient in the risk of adverse birth outcomes among children conceived through MAR using data from a nationally representative sample and controlling for important maternal health and socio-economic characteristics. This topic is of considerable importance in light of the widespread and increasing use of MAR treatments.
Subject: 5141 Sociology
112 Statistics and probability
519 Social and economic geography
medically assisted reproduction
MAR
maternal age
birth outcomes
low birth weight
premature birth
confounding factors
IN-VITRO FERTILIZATION
PRETERM DELIVERY
HEALTH OUTCOMES
TECHNOLOGY
INFERTILITY
PREGNANCY
FINLAND
IMPACT
WOMEN
Peer reviewed: Yes
Rights: cc_by_nc
Usage restriction: openAccess
Self-archived version: publishedVersion


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