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Published on: July 18, 2014
Congenital heart defects in children born after assisted reproductive technology: a CoNARTaS study
Nona Sargisian1, Max Petzold2, Eva Furenäs3
1Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Diagnosvägen 14, 416 85 Gothenburg, Sweden.
Insights
Children conceived via assisted reproductive technology (ART) have a higher risk of congenital heart defects (CHDs) than those conceived spontaneously. While the absolute risk is modest, it is partly linked to multiple pregnancies common in ART.
Area of Science:
- Reproductive Medicine
- Pediatric Cardiology
- Public Health
Background:
- Children born after assisted reproductive technology (ART) exhibit poorer perinatal outcomes compared to spontaneously conceived children.
- Existing research suggests a potential link between ART and adverse infant health outcomes.
Purpose of the Study:
- To investigate the association between assisted reproductive technology (ART) conception and the risk of congenital heart defects (CHDs) in liveborn children.
- To compare the incidence of major and severe CHDs in ART-conceived versus spontaneously conceived children.
Main Methods:
- A large-scale, cross-national study included over 7.7 million liveborn children from Nordic registries (1984-2015).
- Data on ART procedures and congenital heart defects were linked using national registries.
- Multivariable logistic regression was employed to assess the association between ART and CHDs, adjusting for confounders.
Main Results:
- Children conceived via ART had a significantly higher prevalence of major CHDs (1.84% vs. 1.15%) and severe CHDs (0.35% vs. 0.26%) compared to spontaneously conceived children.
- The adjusted odds ratios for major and severe CHDs in ART-conceived children were 1.36 and 1.30, respectively.
- The risk of CHDs was not significantly different between in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), nor between fresh and frozen embryo transfers. Multiple pregnancies, regardless of conception method, showed the highest risk.
Conclusions:
- Assisted reproductive technology-conceived children face an elevated risk of major congenital heart defects, although these conditions are rare.
- The absolute risk increase for CHDs in ART-conceived children is modest.
- Multiple pregnancies, which are more common in ART, contribute to the observed higher risk of CHDs.
Background And Aims:
Children born after assisted reproductive technology (ART) have worse perinatal outcomes compared with spontaneously conceived children. This study investigates whether children conceived after ART have a higher risk of congenital heart defects (CHDs) compared with children born after spontaneous conception (SC).
Methods:
All 7 747 637 liveborn children in Denmark (1994-2014), Finland (1990-2014), Norway (1984-2015), and Sweden (1987-2015), where 171 735 children were conceived after ART, were included. National ART and medical birth registry data were cross-linked with data from other health and population registries. Outcomes were major CHDs, severe CHDs, 6 hierarchical CHD lesion groups, and 10 selected major CHDs, diagnosed prenatally or up to 1 year of age (Denmark, Finland, and Sweden) and prenatally or at birth (Norway). The association between ART and CHDs was assessed with multivariable logistic regression analysis, with adjustment for available confounders.
Results:
Major CHDs were detected in 3159 children born after ART (1.84%) and in 86 824 children born after SC [1.15%; adjusted odds ratio (AOR) 1.36; 95% confidence interval (CI) 1.31-1.41]. Risk was highest in multiples, regardless of conception method. Severe CHDs were detected in 594 children born after ART (0.35%) and in 19 375 children born after SC (0.26%; AOR 1.30; 95% CI 1.20-1.42). Risk was similar between ICSI and IVF and between frozen and fresh embryo transfer.
Conclusions:
Assisted reproductive technology-conceived children have a higher prevalence of major CHDs, being rare, but severe conditions. The absolute risks are, however, modest and partly associated with multiple pregnancies, more prevalent in ART.
