AT ENDO 2015

SAN DIEGO (FRONTLINE MEDICAL NEWS)Compared to white women undergoing assisted reproductive technology, black women were more likely to have preterm births and deliver small-for-gestational-age infants, a large prospective cohort study demonstrated.

“What this means in the long-term outcomes and what this means as far as counseling [ART patients] is a tricky subject, but I think it does warrant more study,” Dr. Snigdha Alur, the study’s lead author, said in an interview at the meeting of the Endocrine Society.

Assisted reproductive technology “is an increasingly employed form of treatment, prompting interest in which factors could predict or influence its success. Despite black women having the highest prevalence of infertility and ample investigation on racial disparities influencing pregnancy outcomes, few have evaluated whether race also affects ART outcomes,” Dr. Alur of the department of obstetrics and gynecology at the University of Rochester (N.Y.) Medical Center, and her associates wrote in a late-breaking abstract.

In an effort to explore whether adverse pregnancy outcomes differ between white and black women using ART, the researchers evaluated data from 1,871 singleton births to women resulting from ART delivered in the Central and Finger Lakes regions of New York state between 2005 and 2013.

The women completed the state’s perinatal data system questionnaire pertaining to their and their partners’ background and their prenatal care, labor course, and birth outcome. These data were combined with obstetric records including birth size and gestational age. A preterm birth was defined as one delivered at less than 37 weeks’ gestational age, while a very preterm birth was defined as one delivered at less than 34 weeks’ gestational age. A small-for-gestational-age (SGA) infant and a very SGA infant were defined as gender-adjusted weight less than 10% and less than 5%, respectively.

Of the 1,871 singleton births studied, 47 were to black women and 1,824 were to white women. After the researchers adjusted for maternal age, smoking status, highest level of education, and other covariates, black women were significantly more likely to have preterm births (odds ratio, 2.63) but not very preterm births (OR, 2.17), compared with their white counterparts. They also had significantly increased odds of having a SGA (OR, 2.71) or a very SGA infant (OR, 3.01), compared with white women.

“It could be that we have to alter some of our counseling and education based on some of these findings,” Dr. Alur said. “Maybe it’s not just the ART, but there could be other factors playing a role [in poorer outcomes for black ART pregnancies] that need further research.”

Dr. Alur reported having no relevant financial conflicts. On Twitter @dougbrunk