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Table 1 Characteristics of Included Studies

From: Caesarean section in pregnancies conceived by assisted reproductive technology: a systematic review and meta-analysis

Study ID and Location

Study Design

Number of Participants, n (singletons)

Maternal Age, mean ± SD number or %

Exposure

NOS Score

Anzola et al. (2019) [26]

France

Retrospective hospital- based/ Matched

Fresh ET = 5883

Frozen ET= 366

SC = 6981

Fresh ET 32.8 ± 4.4

Frozen ET 33.1 ± 4.3

SC not available

IVF and IVF + ICSI, Fresh ET or Frozen ET

8

Apantaku et al. (2008) [27]

England

Retrospective hospital- based/ Matched

ART = 88

SC = 88

ART 33.5 + 4.0

SC-33.2 + 4.1

IFV/ICSI

8

Beyer et al. (2016) [40]

Germany

Retrospective hospital- based

ART = 467

SC = 6417

ART 33.7 + 4.0

SC 28

ART (Fresh ET, Slow-rate Freezing, Vitrification)

7

Buckett et al. (2007) [28]

Canada

Retrospective hospital- based/ Matched

IVF = 133

ICSI = 104

SC = 338

IVF 35

ICSI- 34

SC 34

Fresh ET after IVF

Fresh ET after ICSI

9

Carbillon et al. (2017) [41]

France

Retrospective hospital- based

IVF/ICSI = 119

SC = 7993

Mild ovarian stimulation with ART- 30.2 + 5.9

Multi-follicular stimulation and ART- 29.9 + 6.0

SC - 29.7 + 5.8

IFV/ICSI (Excluded oocyte donation, previous diabetes)

7

Dayan et al. (2018) [42]

Canada

Retrospective population-based

IVF = 1596

SC = 112,813

IVF 35.7 ± 4.6

SC 30.3 ± 5.2

IVF including (ICSI both fresh and frozen embryo transfer)

9

D’Souza et al. (1997) [29]

England

Prospective hospital-based/Matched

IVF = 150

SC = 150

Not available

Fresh ET after IVF

9

Ensing et al. (2015) [30]

Netherlands

Retrospective population-based/ Matched/

adjusted

IVF = 16,177

SC = 1,905,011

IFV 32.7 + 4.6

SC 32.7 + 4.5

IVF as a subgroup

9

Ernstad et al. (2016) [43]

Sweden

Retrospective population-based

Fresh ET = 22,771

Frozen ET = 7795

SC = 1,196,394

>  35 years

All blastocyst (47.1%)

All cleavage (45.7%)

SC (20.4%)

Fresh ET after IVF

Frozen ET after IVF

(excluded oocyte donation)

7

Farhi et al. (2013) [44]

Israel

Prospective hospital-based

IVF = 202

ICSI = 307

SC = 587

ART - 33.1 ± 4.9

SC - 30.1 ± 4.9

ART (IVF and ICSI)

6

Fedder et al. (2013) [18]

Denmark

Retrospective population-based/ Matched/

adjusted

ICSI = 6156

IVF = 11,060

SC = 33,852

ICSI (Group A = 32.78 + 4.27, Group B = 33.16 + 4.05)

IVF (Group C): 34.01 + 4.04

SC (Group D): 30.23 + 4.86

IVF and ICSI

9

Gambadauro et al. (2017) [45]

Sweden

Prospective population-based

IVF = 167

SC = 3116

>  35 years

IVF 46.1%

SC 22.6%

IVF with or without ICSI

7

Gillet et al. (2011) [31]

Belgium

Retrospective population-based/Matched

IVF/ICSI = 1866

SC = 15,228

IVF/ICSI − 37.8 ± 2.4

SC 37.3 ± 2.0

IFV/ICSI

9

Harlev et al. (2018) [46]

Israel

Retrospective hospital- based

IVF = 229

SC = 7929

IVF 41 + 1.35

SC 41 + 1.20

IVF and Ovulation induction

9

Katalinic et al. (2004) [19]

Germany

Prospective hospital-based

ICSI = 2055

SC = 7861

ICSI 32.9 + 3.9

SC 27.0 + 4.7

Fresh embryo transfer (ET) after ICSI

7

Koudstaal et al. (2000) [20] Netherlands

Retrospective hospital- based/ Matched

IVF = 307

SC = 307

IVF 32.8 (+  4.3)

SC 32.7 + (4.4)

Fresh ET after IVF

(excluded frozen and embryo reduction)

9

Liu et al. (2015) [53]

China

Retrospective hospital- based

IVF = 380

SC = 405

IVF/ICSI 31.59 ± 3.48 years

SC 31.31 ± 3.45 years

IVF/ICSI

4

Malchau et al. (2014) [47]

Denmark

Retrospective population-based

IVF = 4135

ICSI = 3635

SC = 229,749

IVF 34.2 (+ 4.4)

ICSI 33.4 (+ 4.3)

SC 30.7 (+ 4.9)

IUI

IVF and ICSI

9

Ochsenkuhn et al. (2003) [32]

Germany

Retrospective hospital- based/ Matched/

adjusted

IVF = 163

SC = 322

IVF 32.6

SC 32.2

IVF

GIFT

9

Olivennes et al. (1993) [21]

France

Retrospective hospital- based

IVF = 162

SC = 5096

IVF 33.6 ± 3.9

SC 29.9 ± 4.7

IVF

7

Olson et al. (2005) [33]

United States

Retrospective hospital- based/ Matched

IVF/ICSI = 645

SC = 4590

IVF 33.9 + 4.6

SC 33.3 + 4.3

IVF/ICSI

8

Perri et al. (2001) [34]

Israel

Retrospective hospital- based/ Matched

ART = 95

SC = 190

ART 32.15 + 4.5

SC 32.13 + 4.5

IFV/ICSI

Transferring both IVF- and ICSI-derived embryos

9

Pinborg et al. (2010) [35]

Denmark

Retrospective population-based/ Matched/

adjusted

Frozen = 957

Fresh =10,329

Non-ART = 4800

Frozen 34.0 (3.8)

Fresh 33.7 (4.0)

Non-ART 30.1 (4.8)

Frozen ET after IVF/ICSI

Fresh ET after IVF/ICSI

8

Poikkeus et al. (2007) [36]

Finland

Retrospective hospital- based/ Matched/

adjusted

IVF/ICSI = 499

(SET = 269; DET = 230)

SC = 15,037

Single ET 32.6 + 3.9

Double ET 34.2 + 3.8

SC 30.3 + 5.3

IFV/ICSI (Single ET or Double ET)

8

Rahu et al. (2019) [48]

Estonia

Retrospective population-based

IVF/ICSI = 1778

SC = 33,555

IVF/ICSI 32.5 ± 3.8

SC 28.6 ± 3.3

IVF/ICSI, autologous

9

Romundstad et al. (2008) [49]

Norway

Retrospective population-based

ART = 8229

SC = 1,200,922

All ranges, and

≥35 years

ART 35%

SC 12%

IFV/ICSI

9

Sazonova et al. (2012) [50]

Sweden

Retrospective population-based

Frozen = 2348

Fresh = 8944

SC = 571,914

n 30–39

ART = 8754

SC = 297,818

n ≥ 40

ART = 836

SC = 18,096

Frozen ET after IVF/ICSI

Fresh ET after IVF/ICSI

(excluded oocyte donation)

9

Shevell et al. (2005) [22]

United States

Prospective hospital-based

ART = 554

SC = 34,286

IVF 34.5 (+ 5.2)

SC 29.9 (+ 5.7)

IVF

ICSI

GIFT/ZIFT

8

Stojnic et al. (2013) [37]

Serbia

Retrospective hospital- based/ Matched /

adjusted

IVF = 351

ICSI = 283

SC = 634

IVF/ICSI 36 ± 4.2

SC 35 ± 4.1

IVF/ICSI (excluded oocyte donation, frozen and vanishing twins)

9

Sun et al. (2014) [38]

Canada

Retrospective hospital- based/ Matched/adjusted

ART = 1327

SC = 5222

All ranges, and

≥ 35 years:

ART 51%

SC 50%

IFV/ICSI

9

Suzuki et al. (2007) [51]

Japan

Retrospective hospital- based

IVF-ET = 89

SC = 849

All ≥35 years

IVF/ICSI

8

Tomic et al. (2011) [39]

Croatia

Retrospective hospital- based/ Matched

IVF = 283

SC = 283

IVF = 37.8 ± 3.9

SC = 37.4 ± 3.8

IVF in advanced age

(excluded oocyte donation, cryopreservation, vanishing twins)

9

Toshimitsu et al. (2014) [52]

Tokyo

Retrospective hospital- based

IVF/ICSI = 116

SC = 662

IVF/ICSI41.5 ± 1.5

SC 41.2 ± 1.4

IVF/ICSI, autologous

7

Wennerholm et al. (2013) [23]

Denmark, Norway and Sweden

Retrospective population-based/Matched/

adjusted

Frozen ET = 6647

Fresh ET = 42,242

SC = 288,542

Frozen: 33.7 + 3.9

Fresh: 33.3 + 4.0

SC:28.5 + 5.0

Frozen ET after IVF/ICSI

9

  1. NOS Newcastle Ottawa Scale, SC Spontaneous Conception, IUI Intrauterine Insemination, ART Assisted Reproductive Technology, IVF In Vitro Fertilization, ICSI Intracytoplasmic Sperm Injection, ET Embryo Transfer, SET Single Embryo Transfer, DET Double Embryo Transfer, GIFT Gamete Intrafallopian Transfer