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Published on: November 20, 2015
The Role of Perinatal Complications in Neurodevelopmental Outcomes of ART-Conceived Children: Prognostic Model for
Sevara Ilmuratova1, Vyacheslav Lokshin1, Zhanar Nurgaliyeva2
1International Clinical Centre of Reproduction "PERSONA", Almaty 050060, Kazakhstan.
Insights
Assisted reproductive technologies (ART) children show brain immaturity signs, but ART is not a risk factor. Perinatal complications, not ART itself, influence neurodevelopmental outcomes in ART-conceived children.
Area of Science:
- Neurology
- Developmental Pediatrics
- Reproductive Medicine
Background:
- Over 13 million children globally have been conceived via assisted reproductive technologies (ART).
- Long-term neurological outcomes for ART-conceived children remain unclear, with inconsistent research findings.
- Kazakhstan has a significant population of ART-conceived children, necessitating localized outcome assessment.
Purpose of the Study:
- To evaluate psychomotor development and nervous system pathologies in Kazakhstani ART-conceived children.
- To compare neurological outcomes between ART-conceived children and naturally conceived controls.
- To develop a predictive model for identifying neurodevelopmental abnormalities in ART-conceived children.
Main Methods:
- A cohort of 252 children (120 ART-conceived, 132 controls) underwent clinical examination and medical history review.
- Neurosonographic assessments were performed to evaluate brain structure and signs of immaturity.
- Univariate and multivariate logistic regression analyses were used to identify predictors of brain immaturity.
Main Results:
- ART-conceived children displayed more neurosonographic signs of brain immaturity compared to controls.
- Multivariate analysis revealed that perinatal complications (prematurity, multiple birth, low birth weight, asphyxia, intrauterine infections) were the primary drivers of observed differences, not ART itself.
- The developed prognostic model identified prematurity and preconceptional progesterone therapy as key predictors of pathological neurodevelopment.
- No significant overall differences in neurological development were found between the ART and control groups.
Conclusions:
- Perinatal factors, rather than ART conception alone, are associated with neurodevelopmental differences.
- Early identification and management of perinatal risks are crucial for optimizing neurodevelopmental outcomes in ART-conceived children.
- Targeted preventive strategies are essential to mitigate potential adverse neurological outcomes.
Abstract:
Background/Objectives: Since the first successful birth following assisted reproductive technologies (ART) several decades ago, the global population of ART-conceived children has surpassed 13 million, with over 40,000 born in Kazakhstan. Despite this growth, questions remain about their long-term neurological outcomes, with existing studies reporting inconsistent findings. This study aimed to assess psychomotor development and the prevalence of nervous system pathologies among ART-conceived children in Kazakhstan and to develop a prognostic model for identifying pathological neurodevelopmental conditions. Methods: We studied 252 children (120 conceived via ART and 132 controls) using clinical examination and medical history data. Brain immaturity predictors were identified by univariate and multivariate logistic regression. Results: ART-conceived children exhibited a higher incidence of neurosonographic signs of brain structure immaturity. However, multivariate analysis indicated that ART itself was not an independent risk factor. Instead, perinatal complications-including prematurity, multiple pregnancy, low birth weight, asphyxia, and intrauterine infections-explained the observed differences. The prognostic model highlighted prematurity and preconceptional progesterone therapy as significant predictors. Overall neurological development did not differ significantly between the groups. Conclusions: These findings underscore the importance of early identification of perinatal risk factors and targeted preventive interventions to mitigate adverse neurodevelopmental outcomes in ART-conceived children.
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