{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T15:42:04Z","timestamp":1782315724794,"version":"3.54.5"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:p>\n            Objective\u2003Among patients \u226545 years, the birth rate in the United States continues to increase. As fertility declines with age, this cohort often utilizes assisted reproductive technology, specifically in vitro fertilization (IVF). While both advancing maternal age and IVF are independently associated with adverse maternal outcomes, data regarding their additive effect are scant. This article aims to determine if patients who conceive via IVF are at increased risk for preterm birth (PTB) compared to patients with non-IVF pregnancies in a very advanced maternal age (vAMA) cohort (\u226545 years).<\/jats:p><jats:p>\n            Study Design\u2003Retrospective cohort study of all pregnant patients \u226545 years old who delivered at a single institution (2014\u20132021). Those with incomplete delivery\/neonatal records or multiples beyond twins were excluded. We compared individuals who conceived via IVF to those who conceived without IVF. The primary outcome was preterm delivery &lt;37 weeks gestation. Secondary outcomes included other adverse perinatal outcomes. Using multivariable logistic regression, we adjusted for multiple gestation as well as confounders found to be significantly different in the univariable analysis and other known risk factors for PTB.<\/jats:p><jats:p>\n            Results\u2003In our study cohort of 420 vAMA patients, individuals who underwent IVF were more likely to be older, privately insured, nulliparous, and with a twin gestation. The PTB rate in vAMA patients who underwent IVF was 24.4 compared to 8.4% in patients who did not use IVF (p\u2009&lt;\u20090.001). After adjusting for confounders, IVF was an independent risk factor for PTB &lt;37 weeks in vAMA patients (adjusted odds ratio {aOR] = 4.3, 95% confidence interval [CI]: 1.7\u201310.4, p\u2009=\u20090.001). In vitro fertilization was also associated with a composite of adverse maternal outcomes (hypertensive disorder of pregnancy, postpartum hemorrhage, blood transfusion, and unplanned hysterectomy) (aOR\u2009=\u20091.7, 95% CI: [1.1\u20132.9], p\u2009=\u20090.03).<\/jats:p><jats:p>\n            Conclusion\u2003In the vAMA population, conception via IVF is associated with an increased risk of PTB &lt;37 weeks.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-2157-3106","type":"journal-article","created":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T23:09:23Z","timestamp":1692659363000},"page":"1532-1537","source":"Crossref","is-referenced-by-count":6,"title":["Risk of Preterm Delivery in Very Advanced Maternal Age Parturients Utilizing In Vitro Fertilization"],"prefix":"10.1055","volume":"41","author":[{"given":"Rachel A.","family":"Newman","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariam","family":"Naqvi","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candace","family":"Levian","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6962-4853","authenticated-orcid":false,"given":"Sarah D.","family":"Smithson","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California"},{"name":"Loma Linda University Health, Loma Linda, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania","family":"Esakoff","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,9,19]]},"reference":[{"issue":"17","key":"ref1","first-page":"1","article-title":"U.S. Department of Health and Human Services; Centers for Disease Control and prevention; National Center for Health Statistics; National Vital Statistics System. Births: Final Data for 2020","volume":"70","author":"MJK Osterman","year":"2022","journal-title":"National Vital Statistics Reports"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"e56583","DOI":"10.1371\/journal.pone.0056583","article-title":"Advanced maternal age and adverse pregnancy outcome: evidence from a large contemporary cohort","volume":"8","author":"L C Kenny","year":"2013","journal-title":"PLoS ONE"},{"issue":"S 01","key":"ref3","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1111\/1471-0528.12659","article-title":"Advanced maternal age and pregnancy outcomes: a multicountry assessment","volume":"121","author":"M Laopaiboon","year":"2014","journal-title":"BJOG"},{"issue":"07","key":"ref4","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1002\/pd.4833","article-title":"The maternal age-related first trimester risks for trisomy 21, 18 and 13 based on Danish first trimester data from 2005 to 2014","volume":"36","author":"T S Hartwig","year":"2016","journal-title":"Prenat Diagn"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1007\/s00404-012-2219-4","article-title":"Maternal and neonatal outcomes of spontaneously conceived pregnancies in mothers over 45 years: a review of the literature","volume":"285","author":"L A Wong-Taylor","year":"2012","journal-title":"Arch Gynecol Obstet"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1055\/s-0031-1285101","article-title":"Pregnancy after age 50: defining risks for mother and child","volume":"29","author":"D H Kort","year":"2012","journal-title":"Am J Perinatol"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.fertnstert.2014.09.037","article-title":"Pregnancy outcomes in very advanced maternal age pregnancies: the impact of assisted reproductive technology","volume":"103","author":"S Jackson","year":"2015","journal-title":"Fertil Steril"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/S1701-2163(16)32112-0","article-title":"Reproductive Endocrinology and Infertility Committee. Retired: pregnancy outcomes after assisted reproductive technology","volume":"28","author":"V M Allen","year":"2006","journal-title":"J Obstet Gynaecol Can"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1136\/bmj.38919.495718.AE","article-title":"Infertility, infertility treatment, and congenital malformations: Danish national birth cohort","volume":"333","author":"J L Zhu","year":"2006","journal-title":"BMJ"},{"issue":"01","key":"ref10","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1002\/uog.18930","article-title":"Risk of spontaneous preterm birth in singleton pregnancies conceived after IVF\/ICSI treatment: meta-analysis of cohort studies","volume":"51","author":"P Cavoretto","year":"2018","journal-title":"Ultrasound Obstet Gynecol"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1136\/bmj.37957.560278.EE","article-title":"Perinatal outcome of singletons and twins after assisted conception: a systematic review of controlled studies","volume":"328","author":"F M Helmerhorst","year":"2004","journal-title":"BMJ"},{"issue":"03","key":"ref12","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1097\/01.AOG.0000114989.84822.51","article-title":"Perinatal outcomes in singletons following in vitro fertilization: a meta-analysis","volume":"103","author":"R A Jackson","year":"2004","journal-title":"Obstet Gynecol"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.bpobgyn.2020.07.005","article-title":"Advanced maternal age and adverse pregnancy outcomes","volume":"70","author":"A P Frick","year":"2021","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"issue":"01","key":"ref14","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/j.1447-0756.2000.tb01196.x","article-title":"Maternal and perinatal outcome of pregnancies after the age of 45","volume":"26","author":"A T Abu-Heija","year":"2000","journal-title":"J Obstet Gynaecol Res"},{"issue":"09","key":"ref15","doi-asserted-by":"crossref","first-page":"1208","DOI":"10.1016\/j.jogc.2017.10.027","article-title":"The effect of very advanced maternal age on maternal and neonatal outcomes: a systematic review","volume":"40","author":"J Leader","year":"2018","journal-title":"J Obstet Gynaecol Can"},{"issue":"05","key":"ref16","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1016\/j.fertnstert.2016.06.021","article-title":"Effect of maternal age on maternal and neonatal outcomes after assisted reproductive technology","volume":"106","author":"A L Wennberg","year":"2016","journal-title":"Fertil Steril"},{"issue":"06","key":"ref17","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.1016\/j.fertnstert.2013.01.128","article-title":"Perinatal outcomes in 375 children born after oocyte donation: a Danish national cohort study","volume":"99","author":"S S Malchau","year":"2013","journal-title":"Fertil Steril"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1053\/ob.1996.v175.a74402","article-title":"Very advanced maternal age: pregnancy after age 45","volume":"175","author":"G A Dildy","year":"1996","journal-title":"Am J Obstet Gynecol"},{"issue":"11","key":"ref19","doi-asserted-by":"crossref","first-page":"2190","DOI":"10.3109\/14767058.2012.684108","article-title":"Outcome of singleton pregnancy in women \u2265 45 years old: a retrospective cohort study","volume":"25","author":"I Laskov","year":"2012","journal-title":"J Matern Fetal Neonatal Med"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2157-3106.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T10:07:27Z","timestamp":1730801247000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2157-3106"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,21]]},"references-count":19,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,7,24]]},"published-print":{"date-parts":[[2024,8]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2157-3106","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,8,21]]},"published":{"date-parts":[[2023,8,21]]}}}