Neonatal death rate four times higher for children born to black women following IVF

Babies conceived following IVF or ICSI in the USA have a fourfold higher neonatal mortality rate if born to black women.

A study published in the journal Pediatrics has investigated the association between adverse birth outcomes and maternal race among women conceiving naturally and using fertility treatment. The researchers hypothesised that women using fertility treatment would be relatively affluent and may not see as large racial disparities in infant mortality as the general population. However, the study revealed that neonatal mortality rate among infants conceived using fertility treatment, defined as treatments where eggs or embryos are handled such as IVF, was 1.6 percent for children born to black women compared with 0.3 percent for children born to white women. The neonatal mortality rate for children conceived naturally was twice as high for children born to black women as those who were born to white women.

'It seems that there are still socioeconomic disparities, even in this particular group of relatively more affluent and educated women who usually tend to go through the fertility treatments,' said Dr Sarka Lisonkova, first author of the study and associate professor in the Department of Obstetrics and Gynaecology at the University of British Columbia in Vancouver, Canada. 'So there could still be residual confounding by socioeconomic status. The other thing is that there might be differential access to health services, particularly in this case of obstetric and maternity care services, and neonatal health services,' she added.

The researchers analysed singleton births in the USA from 2016 and 2017, collecting data on the nature of conception, neonatal and fetal death, preterm birth, and serious neonatal morbidity. Neonatal death was defined as death within 28 days after birth.

For women who conceived naturally the neonatal death rates were 1.1 and 2.0-fold higher for Hispanic and black women respectively compared with white women. This rose even further for women who used IVF to conceive, where neonatal death rates were 4.1-fold higher for black women and 1.9-fold higher for Hispanic and Asian or Pacific Islander women.

Dr Lisonkova said she was 'really surprised' by the overall findings but does not want to discourage black, Hispanic or Asian and Pacific Islander women from receiving fertility treatment. She advised people to have a childbirth plan and continuously consult and follow-up with their doctors. 'Do not hesitate if you feel uncomfortable, or if you feel something is not going right, consult with your physician.' She recommended that healthcare providers maintain good surveillance of babies' health after birth and said providers have a responsibility to listen to women and provide more access to neonatal care.