Additional risk of preterm birth in women of advanced age conceive after IVF/ICSI treatment – results of a Mid-German register analysis

Objective Advanced maternal age (AMA; > 40 years) is an increasing trend and related to preterm birth (PTB) and various pregnancy complications. AMA is also associated with increasing need of artificial reproductive therapy (ART). Up to now, the combination of both risk factors is a less researched issue. Thus, the aim of this study was to quantify the risk of PTB < 37 weeks in pregnancies subsequently to ART, in women > 40 years or in combination of both, compared to women spontaneously conceived.

Study Design Using the database of the Perinatal Survey from 2014 to 2018 of Saxony and Thuringia, 188.632 pregnancies were analysed. 3.748 women (1.99 %) used ART to conceive, whereas 5.910 women (3.13 %) giving birth were 40 years and older. Both risk factors were combined in 320 women (0.17 %). The relative risks (RR) and 95% confidence intervals were calculated using SPSS.

Results AMA > 40 years alone is associated with a nearly twice increased risk for PTB (RR 1.86 (95%CI 1.44-2.40). Women that became pregnant using ART showed more than a doubled risk for PTB (RR 2.25 (95%CI 2.08-2.42). Whereas the PTB rate was only 7.4 % in women < 40 years + spontaneously conceived, combined AMA and ART resulted in 17.2 % of PTB and therefore represent the group of the highest PTB risk (RR 2.33 (95%CI 1.83-2.96).

Conclusion The combination of AMA and ART characterize a high-risk population. These women have to be counselled carefully about pregnancy risks already previously to ART.

Publication History

Article published online:
07 October 2020