Assisted reproductive technology and esophageal atresia: Dangerous liaisons?

Assisted reproductive technologies (ART) are increasingly widespread, accounting for approximately 2 % of all births in Western countries. Concerns have been raised regarding a potential association between ART and congenital anomalies. However, few studies have specifically investigated whether a relationship exists between ART and the development of esophageal atresia (EA). The aim of this study was to analyze the association between EA and ART.

This was a retrospective case-control study including all patients treated for EA between 2013 and 2023. For each patient with EA (case), one control patient with bronchiolitis (and no congenital anomalies), treated during the same period, was selected. The following variables were analyzed: prevalence of ART, gestational age, birth weight, and maternal age. Patients with EA conceived via ART were also compared to those conceived spontaneously in terms of disease complexity. Fisher's exact test and the Mann-Whitney U test were used as appropriate.

A total of 406 patients were analyzed (203 cases and 203 controls). Exposure to ART was significantly higher among EA patients compared to controls [12.3 % vs. 2.9 %; odds ratio: 4.0 (95 % CI: 1.7-9.6); p = 0.0007]. However, when comparing EA patients conceived via ART to those conceived spontaneously, no significant differences in disease complexity were found-except for a higher incidence of type B EA in the ART group.

Our data suggest that patients with EA are more likely to have been conceived following ART compared to controls without congenital anomalies. Nevertheless, ART does not appear to influence the overall complexity of the EA anomaly.