Outcome of Pregnancy After Infertility

Abstract

Pregnancy following a period of infertility was considered to be an increased risk for the fetus. During a period of 3 years (1983 - 85), 748 couples were seen at this infertility clinic; 515 women (68.9%) conceived, and were followed up and studied prospectively. Fifteen of these women moved out of the area. We analysed the results of pregnancies for the remaining 500, (Group 1) and compared them with the outcome for the total obstetric population (Group 2) during the same period. Mean age at conception in the infertility group (Group 1) was 31.8 (.+-. 2.7, 2 SD) years, as compared with 23.7 (.+-. 2.9, 2 SD) in the total hospital obstetric population (Group 2) (p < 0.05). The incidences of spontaneous abortion for the two groups (8 and 6.2%) did not differ (p > 0.05). However, the incidence of ecotopic pregnancy was higher (3.0%) in Group 1 than in Group 2 (1.5%) (p < 0.01). The incidence of pre-existing hypertensive vascular disease (7.7%) complicating pregnancy and multiple pregnancy (4.1%) was significantly higher in Group 1 than in Group 2 (1.5% and 1.4% respectively), (p < 0.01). The incidences of induction of labor (29.5%) and elective operative delivery (10.6%) were higher in Group 1 (p < 0.01). The incidences of infants with birth weight below the tenth centile (12.9%), of fetal distress in labor (14.6%) and a low Apgar score (0-5) (9.5%), were higher in Group 1, but there was no difference in the perinatal mortality rate between the two groups. In general, babies and mothers in the infertility group seemed to fare no worse than those in the total obstetric group delivered at our hospital. This may be because of the intensive antenatal, and intranatal care the patients receive in the infertility group under close supervision by one obstetrician.