Park HS, et al. - Researchers investigated whether pregnancies with vs without ART are associated with an increased risk of unplanned peripartum hysterectomy. Despite low absolute risks, an almost five-fold increased risk of unplanned peripartum hysterectomy was observed. In pregnancies with ART vs those without ART, the occurrence of 1.7 more unplanned peripartum hysterectomies per 1000 deliveries was noted.

Methods

• Using propensity score (PS) matching to control for confounding, researchers performed a retrospective cohort study using a birth cohort from 2014 and 2015 in the United States, which includes more than 7 million births.
• Two groups were formed: pregnancies with and without ART.
• They calculated PSs with demographic, clinical and socioeconomic variables, and matched subjects using the PS with a 1:1 ratio.
• Following PS matching, subjects comprised 43,868 ART pregnancies and 43,868 non-ART pregnancies.
• The risk of unplanned peripartum hysterectomy was primary outcome and was compared by assessing the relative risk and the risk difference between the two groups after PS matching.

Results

• Data revealed similar baseline characteristics between groups after PS matching.
• In women with ART vs those without ART, the observed risk of peripartum hysterectomy was 4.947 times (0.0021 [94/43868] vs 0.0004 [19/43868]; 95% confidence interval [CI] 3.022–8.098).
• Findings showed that the risk difference between two groups was 0.0017 (95% CI 0.0012–0.0022).