Effect of assisted reproductive technologies on neonatal mortality and morbidity

SUMMARYNeonatal morbidity and mortality of 358 infants born by using assisted reproductive technology as study group and 284 naturally conceived infants as control group in Gazi Üniversity Faculty Of Medicine Hospital between 2005-2012 were analyzed retrospectively and compared each other. Multiple births and singleton births were also analyzed and compared each other. Neonatal morbidity in infants born by using assisted reproductive technology was found higher compared to control group significantly. Respiratory system problems, Gastrointestinal system problems and neonatal sepsis were found as major causes of morbidity in study group. Surprisingly neonatal mortality was not found higher than control group (study group 1,02% control group 3,60%) No significant difference was found in incidence of total congenital malformations in both group.İn subgroup analyzis urogenital and gastrointestinal system malformatıon incidence were found higher in study group.Prenatal morbidity was found higher in study group.We concluded that pregnancies and newborns conceived by assisted reproductive technology has much more problems than naturally conceived pregnancies in both prenatal and neotal period.These pregnancies were also more frequently hospitalized with longer time of hospitalization in prenatal and neonatal period. The main causes of higher morbidity in study group were higher incidence of multiple pregnancies (66,48 %in study group 13,83% in control group), prematürity (56,1% in study group 25,3% in control group) and low birth weight (45,2% in study group 34,5% in control group).İn spite of fewer reports noted that the morbidity of singleton infants born following assisted reproductive technology (ART) treatment were also higher than naturally conceived singletons, most of the authors concluded that major cause of high perinatal morbidity in infants born following assisted reproductive technology (ART) treatment were high frequency of multiple gestation in most of the published clinical trials and reviews. Older age of the parents, underlying chromosomal abnormalities, probaple damage due to manipulation of embriyo during assisted reproductive technology, and safety of different techniques are all contreversial issues. Last clinical trials published by the centers that used single embriyo transfer (SET) reported lower incidence of neonatal mortality and morbidity. We concluded that lowering the rate of multiple pregnancies following assisted reproductive technology treatment will decrease the neonatal mortality and morbidity. Larger series of clinical trials comparing the singleton infants of two groups will give us more knowledge about neoanatal mortality and morbidity.