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Cerebral palsy after assisted reproductive technology: a cohort study
Shona Goldsmith1, Sarah Mcintyre1,2, Nadia Badawi1,3
1Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, Australia.
Developmental Medicine and Child Neurology
|October 6, 2017
Summary
Assisted reproductive technology (ART) doubles the birth prevalence of cerebral palsy (CP), primarily due to preterm and multiple births. However, clinical outcomes for children with CP remain similar regardless of conception method.
Area of Science:
- Neuroscience
- Reproductive Medicine
- Pediatrics
Background:
- Assisted reproductive technology (ART) is increasingly utilized globally.
- The association between ART and adverse neurodevelopmental outcomes, such as cerebral palsy (CP), requires further investigation.
- Understanding the specific risks associated with ART is crucial for parental counseling and clinical practice.
Purpose of the Study:
- To determine the birth prevalence of cerebral palsy (CP) in infants conceived via assisted reproductive technology (ART).
- To compare the clinical outcomes of children with CP born after ART versus those conceived naturally.
- To identify factors mediating the increased risk of CP in ART-conceived infants.
Main Methods:
- A cohort study utilizing linked cerebral palsy (CP) and ART register data from live births in Western Australia (1994-2002).
- Birth prevalence of CP was calculated and analyzed using descriptive statistics and logistic regression.
- Data were adjusted for confounding variables and stratified by plurality and gestational age.
Main Results:
- The prevalence of CP was significantly higher in children born after ART (7.2/1000 live births) compared to naturally conceived children (2.5/1000).
- ART singletons had doubled odds of CP, with the risk concentrated in those born before 32 weeks gestation.
- Prevalence of CP was elevated in both ART and naturally conceived twins, with similar clinical outcomes observed between ART and naturally conceived children with CP.
Conclusions:
- Assisted reproductive technology (ART) is associated with a two-fold increase in the birth prevalence of cerebral palsy (CP).
- This increased risk is largely mediated by preterm birth and multiple gestations, though a residual risk persists in very preterm singletons.
- Despite the increased prevalence, clinical outcomes for children with CP are comparable between ART and naturally conceived groups, suggesting ART itself does not worsen CP-related outcomes.
