Disparities in Pregnancy Outcomes Between Caucasian and African American Women Who Conceived Using in Vitro Fertilization (IVF)

Objective: To explore whether the odds of adverse pregnancy outcomes differs between Caucasian and African American women who conceived using In vitro fertilization (IVF). Methods: At delivery, women in the Central and Finger Lakes regions of New York completed the Perinatal Data System (SPDS) questionnaire. Primary analyses compared racial differences in birth outcomes of singleton pregnancies conceived by IVF. Logistic regression was used to examine racial differences in the odds of having a preterm birth (<37 weeks), a very preterm birth (<34 weeks), a small-for-gestational-age (SGA) (<10th%tile), or a very SGA infant (<5th%tile). All analyses adjusted for covariates including maternal age, smoking status, pre-pregnancy weight, gestational weight gain, Medicaid use, employment status, participation in the Federal Supplemental Nutrition Program for Women, Infants, and Children (WIC) and highest level of education. Results: From 2004 to 2014, there were 55 singleton births from IVF to African-American women and 2,089 to Caucasian women out of 368,328 births. In multivariable models, compared to Caucasians, African American women were significantly more likely to have preterm births from IVF (OR=2.6, 95% CI: 1.40, 4.90) and SGA infants (OR=3.2, 95% CI: 1.50, 6.90). African-American women also had (non-significantly) increased odds of having very preterm births (OR=1.7, 95% CI: 0.60, 4.90) and very SGA infants (OR=2.20, 95% CI: 0.80, 6.50). Conclusion: African American women with singleton pregnancies resulting from IVF were more likely to have preterm births and deliver SGA infants compared to Caucasian women using IVF. Given that IVF use is generally limited to women with a higher socioeconomic status, our results provide further evidence that racial disparities in birth outcomes are unlikely to be attributable to socioeconomic status alone. Correspondence to: Snigdha Alur MD, University of Rochester, 601 Elmwood Avenue, Box 668, Rochester, NY 14642, E-mail: snigdha_alur@ urmc.rochester.edu