The importance of prenatal care for women with infertility

This analysis explored the effect of prenatal care on pregnancy outcomes in infertile women.

Prenatal care, including regular doctor’s visits, ultrasounds, and blood tests, is associated with a decreased number of adverse outcomes, such as preterm or stillbirths and low birth weights. Prenatal care is especially important for women diagnosed with infertility, as infertility has been shown to increase the risk of pregnancy loss, chromosomal abnormalities, preeclampsia (high blood pressure), and placenta previa (a condition in which the placenta covers the cervix, leading to increased bleeding during delivery).

Few studies, however, have directly examined the effect of prenatal care on adverse outcomes in infertile women, or what amount of prenatal care is most helpful. The current analysis examined the association between prenatal care and pregnancy outcomes in infertile women, as well as whether adverse outcomes were more likely in infertile women than women with normal fertility.

This retrospective analysis examined the records of 15,056 women diagnosed as infertile and 60,224 women with normal fertility.  Prenatal care and outcomes such as very low birth weight, preterm birth, and labor complications were compared between the two groups. Women were considered to have had inadequate prenatal care if they had less than six doctor’s visits during their pregnancy.

The average number of prenatal visits was higher in infertile women (8.2 visits) compared to non-infertile women (7.9 visits). Infertile women were 10% more likely to have had more than 6 visits and 25% more likely to have had their first visit before 12 weeks of pregnancy.

Infants born to infertile women were 39% more likely to have very low birth weights, and were 15% more likely to be preterm births compared to infants born to fertile women. Infertility increased the rate of labor complications by 13%.

Infertile women with inadequate prenatal care (less than 6 visits) were 15 times more likely to have infants with very low birth weight, and were more than twice as likely to have a preterm birth. Very low birth weight was twice as likely if the first prenatal visit came after the twelfth week of pregnancy compared to those women who had early prenatal care.

The authors suggested that while infertility increased the risks of very low birth weight, preterm birth, and labor complications, a lack of adequate prenatal care further increased the risks for these complications.