General health in a cohort of children conceived after assisted reproductive technology in the United Kingdom: a population-based record-linkage study - 22/12/22
, Mitana Purkayastha, PhD a, Daniel R. Brison, PhD b, Scott M. Nelson, PhD c, g, Stephen A. Roberts, PhD d, Deborah A. Lawlor, PhD e, f, gAbstract |
Background |
Assisted reproductive technology use is increasing annually; however, data on long-term child health outcomes including hospital admissions are limited.
Objective |
This study aimed to examine the potential effects of assisted reproductive technology on any and cause-specific hospital admissions unrelated to perinatal diagnoses.
Study Design |
This was a population-based record-linkage study that included a previously established cohort of children born after assisted reproductive technology in the United Kingdom between 1997 and 2009 (n=63,877), their naturally conceived siblings (n=11,343), and matched naturally conceived population controls (n=127,544) linked to their postnatal health outcomes up to March 31, 2016 to provide robust risk estimates of the potential effects of assisted reproductive technology on any and cause-specific hospital admissions unrelated to perinatal diagnoses. In addition, comparison of hospital admissions by type of treatment was made. Cox regression was used to estimate the risk of hospital admission, and negative binomial regression was used to compare the number of hospital admissions per year.
Results |
This study had 1.6 million person-years of follow-up (mean, 12.9 years; range, 0–19 years), and the mean age at the time of first hospital admission was 6.5 years (range, 0–19 years). Singletons born after assisted reproductive technology had increased risk of any hospital admission compared with naturally conceived population controls (hazard ratio, 1.08; 95% confidence interval, 1.05–1.10) but not naturally conceived siblings (hazard ratio, 1.01; 95% confidence interval, 0.94–1.09). We observed increased risk of diagnoses related to neoplasms and diseases of the respiratory, musculoskeletal, digestive, and genitourinary systems, and lower risk of injury, poisoning, and consequences of external causes compared with naturally conceived population controls. Children born after intracytoplasmic sperm injection had a lower risk of hospital admission compared with those born after in vitro fertilization, although no such differences were observed between children born after fresh embryo transfers and those born after frozen embryo transfers.
Conclusion |
Children born after assisted reproductive technology had greater numbers of hospital admissions compared with naturally conceived population controls. Attenuation of these differences in relation to their naturally conceived siblings suggested that this could be partially attributed to the influence of parental subfertility on child health, increased parental concerns, and an actual increase in morbidity in children born after assisted conception.
Le texte complet de cet article est disponible en PDF.Key words : assisted conception, assisted reproductive technology, cohort, hospital admissions, naturally conceived controls, naturally conceived siblings, record linkage
Plan
| All authors have completed the International Committee of Medical Journal Editors uniform disclosure form at coi_disclosure.pdf and declare: S.M.N. has participated in advisory boards and received speaker or consultancy fees from Access Fertility, Beckman Coulter, Ferring Pharmaceuticals, Finox Biotech, Merck Sharp & Dohme, Roche Diagnostics, and The Fertility Partnership. D.A.L. has received support from Roche Diagnostics and Medtronic Ltd in the last 10 years for research unrelated to that presented in this article. The remaining authors declare no conflict of interest. |
|
| This research was supported by NIHR. This work was supported by the UK Medical Research Council, United Kingdom (grant number MR/L020335/1). D.A.L.’s contribution to the article was additionally supported by the University of Bristol and the UK Medical Research Council via the Medical Research Council Integrative Epidemiology Unit (grant number MC_UU_00011/1-6) and the European Research Council, European Union (grant agreement: 101021566). D.R.B. received additional support from Manchester University National Health Service Foundation Trust. |
|
| Ethical approval and Section 251 support were obtained from the National Health Service (NHS) Research Ethics Committee and the Confidentiality Advisory Group, respectively. Additional data access permissions were sought from the Human Fertilisation and Embryology Authority Register Research Panel, Office for National Statistics (ONS) Micro-Data Release board, and the NHS Digital Medical Register. All researchers with data access obtained NHS Digital Data Security Awareness and ONS Safe Researcher accreditation. |
|
| Data sharing statement: Deidentified linked cohort data can be accessed from the Human Fertilisation and Embryology Authority and National Health Service Digital where it will be held with restricted access. Specific ethical approval from the Research Ethics Committee and the Confidentiality Advisory Group of the Health Research Authority will be required for access. |
|
| Cite this article as: Sutcliffe AG, Purkayastha M, Brison DR, et al. General health in a cohort of children conceived after assisted reproductive technology in the United Kingdom: a population-based record-linkage study. Am J Obstet Gynecol 2023;228:82.e1-17. |
Vol 228 - N° 1
P. 82.e1-82.e17 - janvier 2023 Retour au numéro
Article précédent
- Long-term childhood outcomes for babies born at term who were exposed to antenatal corticosteroids
- Samantha J. Osteen, Ziyi Yang, Alexandra H. McKinzie, Evgenia Teal, Robert S. Tepper, Eli Rhoads, Sara K. Quinney, Laura S. Haneline, David M. Haas
- Effect of pentaerythritol tetranitrate (PETN) on the development of fetal growth restriction in pregnancies with impaired uteroplacental perfusion at midgestation—a randomized trial
- Tanja Groten, Thomas Lehmann, Mariann Städtler, Matej Komar, Jennifer Lucia Winkler, Mateja Condic, Brigitte Strizek, Sven Seeger, Yvonne Jäger, Ulrich Pecks, Christel Eckmann-Scholz, Karl Oliver Kagan, Markus Hoopmann, Constantin S. von Kaisenberg, Lars Brodowski, Anne Tauscher, Susanne Schrey-Petersen, Ulrike Friebe-Hoffmann, Krisztian Lato, Christoph Hübener, Maria Delius, Stefan Verlohren, Dorota Sroka, Dietmar Schlembach, Laura de Vries, Katrina Kraft, Gregor Seliger, Ekkehard Schleußner, PETN Study Group
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?