{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T04:12:49Z","timestamp":1783743169091,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2015,9,2]],"date-time":"2015-09-02T00:00:00Z","timestamp":1441152000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare the risk of adverse pregnancy outcomes in women with and without subfertility and to investigate whether fertility treatment contributes to the adverse outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Register\u2010based retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Aberdeen, Scotland<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>The exposed group included women with subfertility attending Aberdeen Fertility Clinic between 1989 and 2008 and delivering a singleton (<jats:italic>n\u00a0<\/jats:italic>=\u00a03188) or twin (<jats:italic>n<\/jats:italic>\u00a0=\u00a0350) at Aberdeen Maternity Hospital between 1992 and 2009. The unexposed cohort included the remainder of women (singleton <jats:italic>n\u00a0<\/jats:italic>=\u00a052443, twin <jats:italic>n\u00a0<\/jats:italic>=\u00a01125) delivering at Aberdeen Maternity Hospital between 1992 and 2009.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Aberdeen Fertility Centre database and Aberdeen Maternity and Neonatal Databank were linked using Community Health Index numbers. Regression models were used to calculate risk ratios and 95% confidence intervals adjusting for potential confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Maternal outcomes including pre\u2010eclampsia, antepartum haemorrhage, preterm birth, induction of labour; delivery outcomes including operative vaginal delivery, caesarean section; and offspring outcomes including low birthweight, stillbirth and neonatal death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Women with a history of subfertility who delivered a singleton were at a higher risk of pre\u2010eclampsia [adjusted risk ratios (<jats:styled-content style=\"fixed-case\">aRR<\/jats:styled-content>) 1.18, 95% confidence intervals (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) 1.02\u20131.37], antepartum haemorrhage (<jats:styled-content style=\"fixed-case\">aRR<\/jats:styled-content> 1.32, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.18\u20131.47), induction of labour (<jats:styled-content style=\"fixed-case\">aRR<\/jats:styled-content> 1.21, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.11\u20131.31) and very preterm delivery (&lt;32\u00a0weeks) (<jats:styled-content style=\"fixed-case\">aRR<\/jats:styled-content> 1.96, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.53\u20132.49). Subfertile women delivering twins were at a higher risk of being delivered by emergency caesarean section (<jats:styled-content style=\"fixed-case\">aRR<\/jats:styled-content> 2.14, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.26\u20133.66). There were no significant differences in adverse outcomes for singleton pregnancies between the treated and untreated subfertile couples.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Subfertility <jats:italic>per se<\/jats:italic>, rather than fertility treatment, was associated with increased risk of adverse outcomes in singleton pregnancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Large cohort study found higher incidence of adverse outcome in subfertile women having singletons or twins<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.13584","type":"journal-article","created":{"date-parts":[[2015,9,3]],"date-time":"2015-09-03T04:19:19Z","timestamp":1441253959000},"page":"1320-1328","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Obstetric consequences of subfertility: a retrospective cohort study"],"prefix":"10.1111","volume":"123","author":[{"given":"AL","family":"DoPierala","sequence":"first","affiliation":[{"name":"School of Medicine and Dentistry University of Aberdeen Aberdeen UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Bhatta","sequence":"additional","affiliation":[{"name":"Obstetrics and gynaecology Division of Applied Health Sciences School of Medicine and Dentistry University of Aberdeen Aberdeen UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"EA","family":"Raja","sequence":"additional","affiliation":[{"name":"Medical Statistics Team Division of Applied Health Sciences University of Aberdeen Foresterhill Aberdeen UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Bhattacharya","sequence":"additional","affiliation":[{"name":"Obstetrics and gynaecology Division of Applied Health Sciences School of Medicine and Dentistry University of Aberdeen Aberdeen UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Bhattacharya","sequence":"additional","affiliation":[{"name":"Epidemiology Group Division of Applied Health Sciences School of Medicine and Dentistry University of Aberdeen Aberdeen UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,9,2]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dep287"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dem369"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2004.00489.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2010.02.043"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/des347"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dms018"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2009.05.035"},{"key":"e_1_2_6_9_1","first-page":"141","article-title":"Perinatal outcomes of in\u00a0vitro fertilization twins: a systematic review and meta\u2010analyses","volume":"193","author":"McDonald S","year":"2005","journal-title":"Obstet Gynecol"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2013.856415"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2012.05.049"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dms044"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1081\/PRG-200059873"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.92.8.1323"},{"key":"e_1_2_6_15_1","unstructured":"General Register Office for Scotland.Aberdeen City Council Area\u2014Demographic Factsheet.2010[http:\/\/gro-scotland.gov.uk\/statistics\/at-a-glance\/council-areas-map\/index.html]. 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