Assisted reproductive techniques do not impact late neurodevelopmental outcomes of preterm children

Area of Science:

• Neonatal research
• Developmental pediatrics
• Reproductive medicine

Background:

• Assisted reproductive technology (ART) is linked to increased preterm births.
• Limited data exists on the long-term neurodevelopmental outcomes of preterm infants conceived via ART.
• Understanding ART's impact on neurodevelopment in premature infants is crucial.

Purpose of the Study:

• To investigate the neurodevelopmental outcomes at 4 years of age in preterm infants born before 34 weeks of gestational age (GA) following ART.
• To compare neurodevelopmental trajectories between ART-conceived and naturally conceived preterm infants.
• To identify factors associated with non-optimal neurodevelopment in this cohort.

Main Methods:

• A cohort study included 166 ART and 679 naturally conceived preterm infants (born <34 weeks GA) between 2013-2015.
• Neurodevelopment assessed at 4 years using the Age and Stage Questionnaire (ASQ) and need for therapy services.
• Statistical analysis adjusted for socio-economic and perinatal characteristics.

Main Results:

• The ART preterm group had a significantly lower risk of having at least two domains in difficulty on the ASQ (aOR 0.34, 95% CI [0.13-0.88]).
• Male gender, low socio-economic level, and lower gestational age (25-30 weeks) were independently associated with non-optimal neurodevelopment.
• No significant difference was found in the need for therapy services between the ART and naturally conceived groups (p=0.079).

Conclusions:

• Preterm infants conceived via ART demonstrate neurodevelopmental outcomes at 4 years that are comparable, or even superior, to those conceived naturally.
• ART does not appear to confer a disadvantage in long-term neurodevelopment for preterm infants.
• Gestational age at birth, gender, and socio-economic status are key determinants of neurodevelopmental outcomes in preterm infants.