Fertility and Sterility

Louis, Germaine M. Buck, Erin Bell*, Yunlong Xie, Rajeshwari Sundaram, and Edwina Yeung.


To assess parental health status inclusive of infertility and infant outcomes.

Birth cohort with cross-sectional analysis of parental health status and infant outcomes.

Not applicable.

Parents (n = 4,886) and infants (n = 5,845) participating in the Upstate KIDS birth cohort.


Main Outcome Measure(s)
Infertility was defined as [1] sexually active without contraception for 1+ years without pregnancy, [2] ever requiring ≥12 months to become pregnant, and [3] requiring ≥12 months for index pregnancy. Multivariable linear regression with generalized estimating equations estimated the change (β coefficient and 95% confidence interval [CI]) in infant outcomes (gestation, birthweight, length, head circumference, ponderal index) and relative to each disease, including infertility after adjusting for age, body mass index, and infertility treatment.

Prevalence of parental chronic diseases ranged from <1% to 19%, and 21% to 54% for infertility. Maternal hypertension was negatively associated with gestation (β, −0.64; 95% CI, −1.03, −0.25) and birthweight (−151.98; −262.30, −41.67) as was asthma and birthweight (−75.01; −130.40, −19.62). Maternal kidney disease was associated with smaller head circumference (−1.09; −2.17, −0.01), whereas paternal autoimmune disease was associated with larger head circumference (0.87; 0.15, 1.60). Infertility was negatively associated with birthweight (−62.18; −103.78, −20.58), length (−0.33; −0.60, −0.06), and head circumference (−0.35; −0.67, −0.03). Conclusion(s) Infertility was significantly associated with reduced infant size even after accounting for infertility treatment, although the magnitude of reduction varied by definition of infertility. Absence of pregnancy within a year of being at risk may be informative about health.

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* Denotes CSDA Associates, Affiliates, and Staff