TY - JOUR
T1 - The neurodevelopmental morbidity of children born after assisted reproductive technology
T2 - a Nordic register study from the Committee of Nordic Assisted Reproductive Technology and Safety group
AU - Rönö, Kristiina
AU - Rissanen, Essi
AU - Bergh, Christina
AU - Wennerholm, Ulla-Britt
AU - Opdahl, Signe
AU - Romundstad, Liv Bente
AU - Henningsen, Anna-Karina Aaris
AU - Spangmose, Anne Lærke
AU - Pinborg, Anja
AU - Gissler, Mika
AU - Tiitinen, Aila
N1 - Copyright © 2022 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
PY - 2022/5
Y1 - 2022/5
N2 - OBJECTIVE: To assess the risk of neurodevelopmental disorders in singletons born after the use of assisted reproductive technology (ART) compared with singletons born without the use of ART.DESIGN: Nordic register-based study.SETTING: Cross-linked data from Medical Birth Registers and National ART and Patient Registers; liveborn singletons in 1995-2014 in Denmark and Finland, 2005-2015 in Norway, and 1995-2015 in Sweden with follow-up to 2014 (Denmark and Finland) or 2015 (Norway and Sweden).PATIENTS: A total of 5,076,444 singletons: 116,909 (2.3%) born with and 4,959,535 (97.7%) born without the use of ART (non-ART).INTERVENTIONS: In vitro fertilization, intracytoplasmic sperm injection, and fresh and frozen embryo transfer.MAIN OUTCOME MEASURES: The primary outcomes (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, codes) were learning and motor functioning disorders (F80-F83), autism spectrum disorder (F84), attention-deficit/hyperactivity disorder and conduct disorders (F90-F92), and tic disorders (F95). Crude hazard ratios (HRs) and adjusted hazard ratios (aHRs) with 95% confidence intervals were calculated.RESULTS: Singletons in the ART cohort had a higher adjusted risk of learning and motor functioning disorders (HR, 1.01 [0.96-1.07]; aHR, 1.17 [1.11-1.24]) and a tendency toward a higher risk of autism spectrum disorder (HR, 1.12 [1.04-1.21]; aHR, 1.07 [0.98-1.16]) and attention-deficit/hyperactivity disorder and conduct disorders (HR, 0.82 [0.77-0.86]; aHR, 1.17 [0.99-1.12]) but not of tic disorders (HR, 1.21 [1.06-1.38]; aHR, 1.17 [0.96-1.27]). No differences in risk were found between children born after in vitro fertilization and intracytoplasmic sperm injection or after fresh and frozen embryo transfer.CONCLUSIONS: Our findings of only small differences in neurodevelopment between ART and non-ART singletons are reassuring and in line with previous studies.
AB - OBJECTIVE: To assess the risk of neurodevelopmental disorders in singletons born after the use of assisted reproductive technology (ART) compared with singletons born without the use of ART.DESIGN: Nordic register-based study.SETTING: Cross-linked data from Medical Birth Registers and National ART and Patient Registers; liveborn singletons in 1995-2014 in Denmark and Finland, 2005-2015 in Norway, and 1995-2015 in Sweden with follow-up to 2014 (Denmark and Finland) or 2015 (Norway and Sweden).PATIENTS: A total of 5,076,444 singletons: 116,909 (2.3%) born with and 4,959,535 (97.7%) born without the use of ART (non-ART).INTERVENTIONS: In vitro fertilization, intracytoplasmic sperm injection, and fresh and frozen embryo transfer.MAIN OUTCOME MEASURES: The primary outcomes (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, codes) were learning and motor functioning disorders (F80-F83), autism spectrum disorder (F84), attention-deficit/hyperactivity disorder and conduct disorders (F90-F92), and tic disorders (F95). Crude hazard ratios (HRs) and adjusted hazard ratios (aHRs) with 95% confidence intervals were calculated.RESULTS: Singletons in the ART cohort had a higher adjusted risk of learning and motor functioning disorders (HR, 1.01 [0.96-1.07]; aHR, 1.17 [1.11-1.24]) and a tendency toward a higher risk of autism spectrum disorder (HR, 1.12 [1.04-1.21]; aHR, 1.07 [0.98-1.16]) and attention-deficit/hyperactivity disorder and conduct disorders (HR, 0.82 [0.77-0.86]; aHR, 1.17 [0.99-1.12]) but not of tic disorders (HR, 1.21 [1.06-1.38]; aHR, 1.17 [0.96-1.27]). No differences in risk were found between children born after in vitro fertilization and intracytoplasmic sperm injection or after fresh and frozen embryo transfer.CONCLUSIONS: Our findings of only small differences in neurodevelopment between ART and non-ART singletons are reassuring and in line with previous studies.
KW - Autism Spectrum Disorder
KW - Child
KW - Embryo Transfer
KW - Female
KW - Humans
KW - Morbidity
KW - Pregnancy
KW - Reproductive Techniques, Assisted/adverse effects
KW - Tic Disorders
UR - http://www.scopus.com/inward/record.url?scp=85125118011&partnerID=8YFLogxK
U2 - 10.1016/j.fertnstert.2022.01.010
DO - 10.1016/j.fertnstert.2022.01.010
M3 - Journal article
C2 - 35216828
SN - 0015-0282
VL - 117
SP - 1026
EP - 1037
JO - Fertility and Sterility
JF - Fertility and Sterility
IS - 5
ER -