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Fertility treatment use and breastfeeding outcomes

American Journal of Obstetrics and Gynecology Dec 06, 2018

Barrera CM, et al. - Women who conceived spontaneously were compared to women who conceived using fertility treatments (assisted reproductive technology, intrauterine insemination, or fertility-enhancing drugs) in terms of breastfeeding outcomes (initiation and duration at 8 weeks). As per outcomes, mothers who conceive using assisted reproductive technology may breastfeed for shorter durations that may partially be due to an increased likelihood of multiples and infants born preterm.

Methods

  • Maternal-reported data regarding use of fertility treatment and breastfeeding initiation and continuation at 8 weeks were obtained from four states from the 2012–2015 Pregnancy Risk Assessment and Monitoring System (PRAMS)(n=15,615).
  • Data were weighted to represent all women delivering live births within each state; using SAS survey procedures, researchers accounted PRAMS complex survey design.
  • They determined the associations between fertility treatment use and breastfeeding using stepwise, multivariable logistic regression, adjusted for maternal demographics, parity, plurality, mode of delivery, preterm birth, and maternal pre-pregnancy health conditions.

Results

  • Women who conceived spontaneously did not differ from women who conceived using any fertility treatment in terms of breastfeeding outcomes.
  • Women who conceived using assisted reproductive technology displayed lower odds of breastfeeding at 8 weeks, after adjusting for basic demographic covariates (aOR: 0.71; 95% CI: 0.52-0.97) and additionally adjusting for maternal health conditions (aOR: 0.68; 95% CI: 0.49-0.93), but this difference was no longer significant after adjusting for plurality and preterm birth (aOR: 0.74; 95% CI: 0.54-1.02).

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