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Neurological sequelae in children born after in-vitro fertilisation: a population-based study
B Strömberg1, G Dahlquist, A Ericson
1Department of Women and Child Health, University Children's Hospital, 751 85, Uppsala, Sweden. bo.stromberg@kbh.uu.se
Insights
Children born after in-vitro fertilisation (IVF) face a higher risk of neurological issues, particularly cerebral palsy. This increased risk is linked to multiple births and prematurity, suggesting single embryo transfer may be beneficial.
Area of Science:
- Neurology
- Reproductive Medicine
- Pediatrics
Background:
- Limited long-term, population-based data exists on neurological sequelae in children conceived via in-vitro fertilisation (IVF).
- Understanding these risks is crucial for clinical guidance and parental counseling.
Purpose of the Study:
- To compare the incidence of neurological problems in children born after IVF with a control group.
- To identify specific neurological conditions and risk factors associated with IVF conception.
Main Methods:
- A population-based retrospective cohort study was conducted.
- Compared 5,680 IVF-conceived children with 11,360 matched controls.
- Included a separate analysis for IVF twins (n=2,060) against twin controls (n=4,120), utilizing data from Swedish habilitation centers.
Main Results:
- Children born after IVF showed a higher likelihood of needing habilitation services (OR 1.7).
- Significantly increased risk for cerebral palsy (OR 3.7) and suspected developmental delay (4-fold increase) was observed in IVF-born children.
- No increased risk of neurological sequelae was found in IVF twins compared to control twins; low birth weight and prematurity were significant factors.
Conclusions:
- Children conceived via IVF exhibit an elevated risk of neurological problems, notably cerebral palsy.
- The higher incidence of twin pregnancies, low birth weight, and prematurity in IVF births contribute significantly to these risks.
- Recommends single embryo transfer during IVF procedures to mitigate potential neurological risks.
Background:
There is an absence of population-based long-term studies on the risk of neurological sequelae in children born after in-vitro fertilisation (IVF). Our aim was to compare the frequency of such problems between IVF-born children and controls.
Methods:
We did a population-based retrospective cohort study in which we compared development of neurological problems in 5680 children born after IVF, with 11360 matched controls. For 2060 twins born after IVF, a second set of controls (n=4120), all twins, were selected. We obtained data on neurological problems from the records of the Swedish habilitation centres.
Findings:
Children born after IVF are more likely to need habilitation services than controls (odds ratio 1.7, 95% CI 1.3-2.2). For singletons, the risk was 1.4 (1.0-2.1). The most common neurological diagnosis was cerebral palsy, for which children born after IVF had an increased risk of 3.7(2.0-6.6), and IVF singletons of 2.8 (1.3-5.8). Suspected developmental delay was increased four-fold (1.9-8.3) in children born after IVF. Twins born after IVF did not differ from control twins with respect to risk of neurological sequelae. Low-birthweight and premature infants were more likely to need habilitation than fullterm babies. Maternal age did not affect risk.
Interpretation:
Our study suggests that children born after IVF have an increased risk of developing neurological problems, especially cerebral palsy. These risks are largely due to the high frequency of twin pregnancies, low birthweight, and prematurity among babies born after IVF. To limit these risks, we recommend that only one embryo should be transferred during IVF.
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