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Demographic, obstetric, and perinatal data were compared between pregnancies conceived with <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> (in vitro fertilization [<jats:styled-content style=\"fixed-case\">IVF<\/jats:styled-content>] or ovulation induction) and those conceived spontaneously. Multiple regression models were used to define independent predictors of adverse outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 8244 singleton pregnancies were included; 229 (2.8%) following <jats:styled-content style=\"fixed-case\">IVF<\/jats:styled-content>, 86 (1.0%) following ovulation induction, and 7929 (96.2%) were spontaneous. Preterm delivery (<jats:italic>P&lt;<\/jats:italic>0.001), fetal growth restriction (<jats:styled-content style=\"fixed-case\">FGR<\/jats:styled-content>) (<jats:italic>P&lt;<\/jats:italic>0.001), and cesarean delivery (<jats:italic>P&lt;<\/jats:italic>0.001) demonstrated linear associations with the conception mode; the highest rates for each were observed for <jats:styled-content style=\"fixed-case\">IVF<\/jats:styled-content>, with decreased rates for ovulation induction and spontaneous conception. The incidence of gestational diabetes and hypertensive disorders were highest among pregnancies following <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content>. No association was observed between conception mode and perinatal mortality. Multivariate logistic regression demonstrated that <jats:styled-content style=\"fixed-case\">IVF<\/jats:styled-content> was independently associated with increased odds of preterm delivery (<jats:italic>P&lt;<\/jats:italic>0.001) and <jats:styled-content style=\"fixed-case\">FGR<\/jats:styled-content> (<jats:italic>P=<\/jats:italic>0.027) compared with spontaneous conception.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Among patients of advanced maternal age, <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> were independently associated with increased <jats:styled-content style=\"fixed-case\">FGR<\/jats:styled-content> and preterm delivery rates compared with spontaneous pregnancies; perinatal mortality was 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