Preterm birth in young women and singleton pregnancy following IVF in the kingdom of Bahrain

Invitro Fertilization (IVF) rate has been constantly increasing since 1986. Preterm birth is a known complication of IVF pregnancies. Analysis of the risk of preterm birth in young mothers conceived singleton pregnancy through IVF/Intra cytoplasmic sperm injection (ICSI) is an important assessment to counsel young patients contemplating IVF treatment. This is a retrospective analysis of births from young patients of ≤35 years, following natural/ IVF conception between January 2019 and February 2020 at Bahrain Defense Force Hospital. We studied the women who had conceived through ART (Assisted Reproductive Technology) against women conceived naturally. Preterm birth between 24 and 37 weeks of gestation was analyzed. The risk factors for preterm delivery such as multiple pregnancy, placental insufficiency, vaginal infections as well as iatrogenic preterm deliveries were analyzed. P-Value<0.05 is considered statistically significant. The study included 2646 women. IVF conception was reported in 56 patients with rate of 2.1%. Our study showed that gestational age at delivery was earlier for IVF conception at 36.5 weeks compared to 39 weeks for natural conception. Multiple logistic regression analysis after adjusting other risk factors of preterm delivery, confirmed increased risk of delivery before 37 weeks after IVF singleton conception with OR 2.3 and 95% CI(1.1-4.7) P = 0.02. Risk of delivery before 32 weeks not increased with IVF conception OR 2.3 with 95% CI of 0.9-5.9 P=0.09, but the risk significantly increased for delivery before 28 weeks with OR 4.5 with 95% CI(1.2-16.8)P=0.02. Preterm deliveries are significantly increased in women aged less than 35 years old after IVF/ICSI with singleton pregnancies.