Parental Health Status and Infant Outcomes: Upstate KIDS Study

Fertil Steril. 2018 Feb;109(2):315-323. doi: 10.1016/j.fertnstert.2017.10.009. Epub 2018 Jan 17.

Abstract

Objective: To assess parental health status inclusive of infertility and infant outcomes.

Design: Birth cohort with cross-sectional analysis of parental health status and infant outcomes.

Setting: Not applicable.

Patient(s): Parents (n = 4,886) and infants (n = 5,845) participating in the Upstate KIDS birth cohort.

Intervention(s): None.

Main outcome measure(s): Infertility was defined as [1] sexually active without contraception for 1+ years without pregnancy, [2] ever requiring ≥12 months to become pregnant, and [3] requiring ≥12 months for index pregnancy. Multivariable linear regression with generalized estimating equations estimated the change (β coefficient and 95% confidence interval [CI]) in infant outcomes (gestation, birthweight, length, head circumference, ponderal index) and relative to each disease, including infertility after adjusting for age, body mass index, and infertility treatment.

Result(s): Prevalence of parental chronic diseases ranged from <1% to 19%, and 21% to 54% for infertility. Maternal hypertension was negatively associated with gestation (β, -0.64; 95% CI, -1.03, -0.25) and birthweight (-151.98; -262.30, -41.67) as was asthma and birthweight (-75.01; -130.40, -19.62). Maternal kidney disease was associated with smaller head circumference (-1.09; -2.17, -0.01), whereas paternal autoimmune disease was associated with larger head circumference (0.87; 0.15, 1.60). Infertility was negatively associated with birthweight (-62.18; -103.78, -20.58), length (-0.33; -0.60, -0.06), and head circumference (-0.35; -0.67, -0.03).

Conclusion(s): Infertility was significantly associated with reduced infant size even after accounting for infertility treatment, although the magnitude of reduction varied by definition of infertility. Absence of pregnancy within a year of being at risk may be informative about health.

Keywords: Birth size; fecundity; health; infertility; pregnancy.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Birth Weight
  • Cross-Sectional Studies
  • Fathers*
  • Female
  • Gestational Age
  • Head / anatomy & histology
  • Health Status*
  • Humans
  • Infant, Newborn
  • Infertility, Female / diagnosis
  • Infertility, Female / epidemiology*
  • Infertility, Female / therapy
  • Infertility, Male / diagnosis
  • Infertility, Male / epidemiology*
  • Infertility, Male / therapy
  • Linear Models
  • Live Birth
  • Male
  • Maternal Health*
  • Multivariate Analysis
  • New York / epidemiology
  • Noncommunicable Diseases / epidemiology*
  • Pregnancy
  • Pregnancy Complications / diagnosis
  • Pregnancy Complications / epidemiology*
  • Prevalence
  • Reproductive Techniques, Assisted
  • Risk Factors
  • Time-to-Pregnancy