The impact of assisted reproductive technology and ovulation induction on breech presentation: A whole of population-based cohort study.

Chen, AX; Hunt, RW; Palmer, KR; Bull, CF; Callander, EJ

The impact of assisted reproductive technology and ovulation induction on breech presentation: A whole of population-based cohort study.

Chen, AX Hunt, RW Palmer, KR Bull, CF Callander, EJ

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Publisher:: Wiley
Publication Type:: Journal Article
Citation:: Aust N Z J Obstet Gynaecol, 2023, 63, (3), pp. 434-440
Issue Date:: 2023-06

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Field	Value	Language
dc.contributor.author	Chen, AX
dc.contributor.author	Hunt, RW
dc.contributor.author	Palmer, KR
dc.contributor.author	Bull, CF
dc.contributor.author	Callander, EJ
dc.date.accessioned	2023-09-15T04:16:06Z
dc.date.available	2023-02-15
dc.date.available	2023-09-15T04:16:06Z
dc.date.issued	2023-06
dc.identifier.citation	Aust N Z J Obstet Gynaecol, 2023, 63, (3), pp. 434-440
dc.identifier.issn	0004-8666
dc.identifier.issn	1479-828X
dc.identifier.uri	http://hdl.handle.net/10453/172117
dc.description.abstract	AIMS: Multiple studies have suggested a likely association between breech presentation and assisted reproductive technology (ART) for conception. The aims were to determine whether conception via in vitro fertilisation (IVF) and ovulation induction (OI) is associated with fetal malpresentation at birth and to ascertain what mediating factors most significantly contribute to fetal malpresentation. METHODS: This whole-population-based cohort study included 355 990 singleton pregnancies born in Queensland, Australia, between July 2012 and July 2018. Multinomial logistic regression models estimated the adjusted odds of breech, transverse/shoulder and face/brow malpresentations in pregnancies conceived via spontaneous conception, OI (OI group) and IVF with or without intracytoplasmic sperm injection (ART group). RESULTS: After adjustment for potential confounding factors, breech presentation occurred approximately 20% more often in singleton pregnancies conceived via both ART (adjusted odds ratio: 1.20, 95% confidence interval: 1.10-1.30, P < 0.001) and OI (1.21, 95% confidence interval: 1.04-1.39, P < 0.05). No significant associations were observed between the three modes of conception and transverse/shoulder or face/brow presentations. Low birthweight was found to be the most significant mediating factor for breech presentation in pregnancies conceived via ART and OI. CONCLUSIONS: Similar levels of increased odds of breech presentation are present in pregnancies conceived via OI and ART, suggesting a shared underlying mechanism for the aetiology of breech presentation. For women who are considering or have conceived via these methods, counselling with respect to this increased risk is recommended.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Wiley
dc.relation.ispartof	Aust N Z J Obstet Gynaecol
dc.relation.isbasedon	10.1111/ajo.13663
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1114 Paediatrics and Reproductive Medicine, 1117 Public Health and Health Services
dc.subject.classification	Obstetrics & Reproductive Medicine
dc.subject.classification	3215 Reproductive medicine
dc.subject.classification	4204 Midwifery
dc.subject.mesh	Pregnancy
dc.subject.mesh	Infant, Newborn
dc.subject.mesh	Male
dc.subject.mesh	Humans
dc.subject.mesh	Female
dc.subject.mesh	Cohort Studies
dc.subject.mesh	Breech Presentation
dc.subject.mesh	Semen
dc.subject.mesh	Reproductive Techniques, Assisted
dc.subject.mesh	Ovulation Induction
dc.subject.mesh	Semen
dc.subject.mesh	Humans
dc.subject.mesh	Breech Presentation
dc.subject.mesh	Reproductive Techniques, Assisted
dc.subject.mesh	Ovulation Induction
dc.subject.mesh	Cohort Studies
dc.subject.mesh	Pregnancy
dc.subject.mesh	Infant, Newborn
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Pregnancy
dc.subject.mesh	Infant, Newborn
dc.subject.mesh	Male
dc.subject.mesh	Humans
dc.subject.mesh	Female
dc.subject.mesh	Cohort Studies
dc.subject.mesh	Breech Presentation
dc.subject.mesh	Semen
dc.subject.mesh	Reproductive Techniques, Assisted
dc.subject.mesh	Ovulation Induction
dc.title	The impact of assisted reproductive technology and ovulation induction on breech presentation: A whole of population-based cohort study.
dc.type	Journal Article
utslib.citation.volume	63
utslib.location.activity	Australia
utslib.for	1114 Paediatrics and Reproductive Medicine
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	open_access	*
dc.date.updated	2023-09-15T04:16:05Z
pubs.issue	3
pubs.publication-status	Published
pubs.volume	63
utslib.citation.issue	3

Abstract:

AIMS: Multiple studies have suggested a likely association between breech presentation and assisted reproductive technology (ART) for conception. The aims were to determine whether conception via in vitro fertilisation (IVF) and ovulation induction (OI) is associated with fetal malpresentation at birth and to ascertain what mediating factors most significantly contribute to fetal malpresentation. METHODS: This whole-population-based cohort study included 355 990 singleton pregnancies born in Queensland, Australia, between July 2012 and July 2018. Multinomial logistic regression models estimated the adjusted odds of breech, transverse/shoulder and face/brow malpresentations in pregnancies conceived via spontaneous conception, OI (OI group) and IVF with or without intracytoplasmic sperm injection (ART group). RESULTS: After adjustment for potential confounding factors, breech presentation occurred approximately 20% more often in singleton pregnancies conceived via both ART (adjusted odds ratio: 1.20, 95% confidence interval: 1.10-1.30, P < 0.001) and OI (1.21, 95% confidence interval: 1.04-1.39, P < 0.05). No significant associations were observed between the three modes of conception and transverse/shoulder or face/brow presentations. Low birthweight was found to be the most significant mediating factor for breech presentation in pregnancies conceived via ART and OI. CONCLUSIONS: Similar levels of increased odds of breech presentation are present in pregnancies conceived via OI and ART, suggesting a shared underlying mechanism for the aetiology of breech presentation. For women who are considering or have conceived via these methods, counselling with respect to this increased risk is recommended.

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http://hdl.handle.net/10453/172117