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Assisted Reproductive Technology and Early Intervention Program Enrollment.

Hafsatou Diop1, Daksha Gopal2, Howard Cabral3

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Children conceived via assisted reproductive technology (ART) and those born to subfertile mothers have a higher likelihood of enrolling in Early Intervention (EI) services. This increased risk is independent of preterm birth rates.

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Area of Science:

  • Reproductive Medicine
  • Developmental Pediatrics
  • Public Health

Background:

  • Assisted reproductive technology (ART) and maternal subfertility are increasingly common.
  • Early Intervention (EI) services support children with developmental delays.
  • Understanding factors influencing EI enrollment is crucial for resource allocation and timely support.

Purpose of the Study:

  • To compare the prevalence of EI enrollment among singleton children conceived via ART, those born to subfertile mothers (without ART), and naturally conceived children.
  • To assess the direct and indirect effects of ART and subfertility on EI enrollment, considering preterm birth as a mediator.

Main Methods:

  • A retrospective cohort study in Massachusetts comparing singleton births across ART, Subfertile, and Fertile groups (n=318,359).
  • Maternal and infant characteristics were analyzed using chi-squared statistics.
  • Causal inference models (natural direct effect, natural indirect effect) were employed to estimate the impact of ART and subfertility on EI enrollment.

Main Results:

  • Children conceived via ART had 27% higher odds of EI enrollment compared to naturally conceived children (OR=1.27, 95% CI: 1.19–1.36).
  • Children born to subfertile mothers also showed 20% higher odds of EI enrollment (OR=1.20, 95% CI: 1.12–1.29).
  • These elevated risks persisted even when controlling for preterm birth.

Conclusions:

  • Both ART conception and maternal subfertility are associated with an increased risk of EI enrollment in singleton children.
  • These findings highlight the need for clinicians to counsel prospective parents on potential child development outcomes related to ART and subfertility.