Predicting Live Birth, Preterm Delivery, and Low Birth Weight in Infants Born from In Vitro Fertilisation: A Prospective Study of 144,018 Treatment Cycles
- Publication Date
- January 04, 2011
- Journal
- PLOS Medicine
- Authors
- Scott M. Nelson & Debbie A. Lawlor
- Volume
- 8
- Issue
- 1
- Pages
- e1000386
- DOI
- https://dx.plos.org/10.1371/journal.pmed.1000386
- Publisher URL
- http://journals.plos.org/plosmedicine/article?id=10.1371%2Fjournal.pmed.1000386
- PubMed
- http://www.ncbi.nlm.nih.gov/pubmed/21245905
- PubMed Central
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3014925
- Europe PMC
- http://europepmc.org/abstract/MED/21245905
- Web of Science
- 000286594200002
- Scopus
- 79951596286
- Mendeley
- http://www.mendeley.com/research/predicting-live-birth-preterm-delivery-low-birth-weight-infants-born-vitro-fertilisation-prospective-8
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Mendeley | Further Information
{"title"=>"Predicting live birth, preterm delivery, and low birth weight in infants born from in vitro fertilisation: A prospective study of 144,018 treatment cycles", "type"=>"journal", "authors"=>[{"first_name"=>"Scott M.", "last_name"=>"Nelson", "scopus_author_id"=>"12776474100"}, {"first_name"=>"Debbie A.", "last_name"=>"Lawlor", "scopus_author_id"=>"7102452820"}], "year"=>2011, "source"=>"PLoS Medicine", "identifiers"=>{"pui"=>"361278287", "sgr"=>"79951596286", "issn"=>"15491277", "pmid"=>"21245905", "scopus"=>"2-s2.0-79951596286", "doi"=>"10.1371/journal.pmed.1000386", "isbn"=>"1549-1676"}, "id"=>"6cb1ead6-ad56-3438-a2bb-25998bee6204", "abstract"=>"BACKGROUND: The extent to which baseline couple characteristics affect the probability of live birth and adverse perinatal outcomes after assisted conception is unknown.\\n\\nMETHODS AND FINDINGS: We utilised the Human Fertilisation and Embryology Authority database to examine the predictors of live birth in all in vitro fertilisation (IVF) cycles undertaken in the UK between 2003 and 2007 (n = 144,018). We examined the potential clinical utility of a validated model that pre-dated the introduction of intracytoplasmic sperm injection (ICSI) as compared to a novel model. For those treatment cycles that resulted in a live singleton birth (n = 24,226), we determined the associates of potential risk factors with preterm birth, low birth weight, and macrosomia. The overall rate of at least one live birth was 23.4 per 100 cycles (95% confidence interval [CI] 23.2-23.7). In multivariable models the odds of at least one live birth decreased with increasing maternal age, increasing duration of infertility, a greater number of previously unsuccessful IVF treatments, use of own oocytes, necessity for a second or third treatment cycle, or if it was not unexplained infertility. The association of own versus donor oocyte with reduced odds of live birth strengthened with increasing age of the mother. A previous IVF live birth increased the odds of future success (OR 1.58, 95% CI 1.46-1.71) more than that of a previous spontaneous live birth (OR 1.19, 95% CI 0.99-1.24); p-value for difference in estimate <0.001. Use of ICSI increased the odds of live birth, and male causes of infertility were associated with reduced odds of live birth only in couples who had not received ICSI. Prediction of live birth was feasible with moderate discrimination and excellent calibration; calibration was markedly improved in the novel compared to the established model. Preterm birth and low birth weight were increased if oocyte donation was required and ICSI was not used. Risk of macrosomia increased with advancing maternal age and a history of previous live births. Infertility due to cervical problems was associated with increased odds of all three outcomes-preterm birth, low birth weight, and macrosomia.\\n\\nCONCLUSIONS: Pending external validation, our results show that couple- and treatment-specific factors can be used to provide infertile couples with an accurate assessment of whether they have low or high risk of a successful outcome following IVF.", "link"=>"http://www.mendeley.com/research/predicting-live-birth-preterm-delivery-low-birth-weight-infants-born-vitro-fertilisation-prospective-8", "reader_count"=>73, "reader_count_by_academic_status"=>{"Unspecified"=>2, "Professor > Associate Professor"=>1, "Librarian"=>1, "Student > Doctoral Student"=>2, "Researcher"=>13, "Student > Ph. D. Student"=>15, "Student > Postgraduate"=>5, "Student > Master"=>20, "Other"=>6, "Student > Bachelor"=>4, "Lecturer"=>2, "Lecturer > Senior Lecturer"=>1, "Professor"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>2, "Professor > Associate Professor"=>1, "Librarian"=>1, "Student > Doctoral Student"=>2, "Researcher"=>13, "Student > Ph. D. Student"=>15, "Student > Postgraduate"=>5, "Student > Master"=>20, "Other"=>6, "Student > Bachelor"=>4, "Lecturer"=>2, "Lecturer > Senior Lecturer"=>1, "Professor"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>8, "Biochemistry, Genetics and Molecular Biology"=>4, "Mathematics"=>2, "Medicine and Dentistry"=>38, "Agricultural and Biological Sciences"=>6, "Chemistry"=>1, "Psychology"=>2, "Social Sciences"=>6, "Computer Science"=>4, "Immunology and Microbiology"=>1, "Economics, Econometrics and Finance"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>38}, "Chemistry"=>{"Chemistry"=>1}, "Social Sciences"=>{"Social Sciences"=>6}, "Psychology"=>{"Psychology"=>2}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>1}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>6}, "Computer Science"=>{"Computer Science"=>4}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>4}, "Mathematics"=>{"Mathematics"=>2}, "Unspecified"=>{"Unspecified"=>8}}, "reader_count_by_country"=>{"Canada"=>1, "Norway"=>1, "Italy"=>1, "United Kingdom"=>1, "Nigeria"=>1}, "group_count"=>7}CrossRef
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Scopus | Further Information
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Journal Comments | Further Information
- {"type"=>"COMMENT", "annotationUri"=>"info:doi/10.1371/annotation/8a3c8b22-d140-469a-84dd-7f6650aab3ba", "title"=>"Does the i-app predict the information that prospective parents really seek? ", "body"=>"Sir,\n\nIn IVF, the challenge is to achieve a high pregnancy rate with minimal adverse outcomes (El-Toukhy et al., 2006). ‘Live birth’ alone is inadequate to judge success, as it fails to capture infant mortality and morbidity largely related to prematurity. As acknowledged by Nelson and Lawlor (2011), infant complications are important adverse outcomes of IVF and it is increasingly recognised that “the singleton, term gestation, live birth rate per cycle initiated should be considered the best endpoint for assisted reproduction technology” (Min et al., 2004). We welcome their recent paper promisingly entitled “predicting live birth, preterm delivery and low birth weight”. Nonetheless, the authors used live birth (surviving one month) as the sole outcome for the primary prospective analysis to predict IVF outcome, paying little heed to gestation or health of the resulting neonate, despite access to 4 years of outcome data of 144,018 cycles collected by the HFEA (2003-2007). A secondary retrospective analysis of baseline couple characteristics, performed on a far smaller group (n=24,266) identified risk factors associated with the important complications of prematurity and birth weight, but only considering cases demonstrating a single fetal heart beat at 8 weeks (rather than from start of IVF treatment) and resulting in a singleton live baby surviving one month. Whilst this has some validity as a separate analysis, defining entry criteria by outcome has little scientific legitimacy as part of a ‘risk predictor’ for ‘successful outcome’ as implied by the title of the paper and subsequent media coverage. Moreover, by excluding twins (a potent cause of prematurity and birth weight) the authors automatically fail to capture the true infant morbidity of IVF. Thus the claim that the model can “provide couples with an accurate assessment of whether they have a low or high risk of successful outcome following IVF” at the start of their treatment is overstated [our emphasis in italics]. \n\nThe associated online IVF calculator has been hailed as “incredibly accurate” (Guardian, 2011), though the analysis of infant complications has no place in the predictor. Readers and prospective parents interested in the health of their children could be confused by the use of ‘live birth’ - an inadequate surrogate marker. Although potentially misleading to the novel i-phone app users as presently construed, we look forward to scientific reports of the risk prediction tool in action, and especially to refinements based on better endpoints. \n\nNatasha Hezelgrave\nAcademic Clinical Fellow, Obstetrics and Gynaecology\n\nSusan Bewley\nConsultant Obstetrician\nGuy’s & St Thomas’ NHS Foundation Hospitals\n", "isRemoved"=>false, "created"=>"2011-06-10T22:19:53Z", "lastModified"=>"2011-06-10T22:19:53Z", "creator"=>{"userId"=>"172163"}, "highlightedText"=>"", "competingInterestStatement"=>{"creatorWasPrompted"=>true, "hasCompetingInterests"=>false}, "parentArticle"=>{"doi"=>"info:doi/10.1371/journal.pmed.1000386", "state"=>"published", "journals"=>{"PLoSMedicine"=>{"journalKey"=>"PLoSMedicine", "eIssn"=>"1549-1676", "title"=>"PLOS Medicine"}}}, "replyTreeSize"=>0, "mostRecentActivity"=>"2011-06-10T22:19:53Z", "replies"=>[]}
- {"type"=>"COMMENT", "annotationUri"=>"info:doi/10.1371/annotation/01aa4ad5-0279-450e-8421-6051333ab8ce", "title"=>"Publisher's Note: Errors in Text S2", "body"=>"In Text S2, there were errors in the values reported in Tables 1-4. Please find the correct Text S2 here: http://www.plosmedicine.org/corrections/pmed.1000386.s010.cn.docx", "isRemoved"=>false, "created"=>"2013-05-14T19:29:27Z", "lastModified"=>"2013-05-14T21:00:03Z", "creator"=>{"userId"=>"172479"}, "highlightedText"=>"", "competingInterestStatement"=>{"creatorWasPrompted"=>true, "hasCompetingInterests"=>false}, "parentArticle"=>{"doi"=>"info:doi/10.1371/journal.pmed.1000386", "state"=>"published", "journals"=>{"PLoSMedicine"=>{"journalKey"=>"PLoSMedicine", "eIssn"=>"1549-1676", "title"=>"PLOS Medicine"}}}, "replyTreeSize"=>0, "mostRecentActivity"=>"2013-05-14T19:29:27Z", "replies"=>[]}
- {"id"=>"736214906811387905", "text"=>"@EversJlh Analysis of UK data shows ICSI beneficial for live birth and same in validation data \nhttps://t.co/pYdXj9f2p8", "created_at"=>"2016-05-27T15:18:06Z", "user"=>"profscottnelson", "user_name"=>"Scott Nelson", "user_profile_image"=>"http://pbs.twimg.com/profile_images/679299777239064576/_k2RxUZf_normal.jpg"}
- {"id"=>"736658159306219520", "text"=>"RT @profscottnelson: @EversJlh Analysis of UK data shows ICSI beneficial for live birth and same in validation data \nhttps://t.co/pYdXj9f2…", "created_at"=>"2016-05-28T20:39:26Z", "user"=>"DrLlacer", "user_name"=>"Joaquin Llacer", "user_profile_image"=>"http://pbs.twimg.com/profile_images/624723484816621568/07ccgtgn_normal.jpg"}
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PMC Usage Stats | Further Information
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Relative Metric
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