Unrecognised healthcare consequences of children born following assisted reproductive technology

• Main Author: McComiskey, Mark Henry
• Published: Queen's University Belfast 2014
• Subjects: 618.92
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.675460

The consensus is that children born following ART are delivered earlier and at a lower birthweight that those naturally conceived and have a higher likelihood of requiring admission to a neonatal intensive care unit (NICU). The longer term prospects for artificially conceived children seem comparable to the naturally conceived population for the majority of medical conditions. This study examined NICU admission registry data of children born 111/2001 to 31/12/2007. Odds ratios (OR) for NICU admission were produced. All paediatric hospital admissions in Northern Ireland 1/7/1996 through 3016/2009 were also studied. Standardised admission ratios (SAR's) for children up to 13 years old born following ART were calculated. Unadjusted OR for NICU admission was 0.92 (95% CI 0.71, 1.18) for singleton~ and 0.83 (95% CI 0.69, 0.99) for twins. Adjustment for hospital, gestation and year showed OR for NICU admission to be 0.68 (95% CI 0.49, 0.93) for singletons and 0.76 (95% CI 0.60, 0.97) for twins. SAR for all- and first hospital admissions in ART children were 80 (95% CI 76, 84) and 74 (95% CI 68, 80) respectively. Children born fOllowing IVF had increased all-hospital SAR compared to those born following ICSI (SAR 85, 95% CI 80, 90 vs. SAR 71,95% C164, 77; p=0.001). Those born following fresh embryo had increased all-hospital SAR compared to those born fallowing frozen embryo transfer. All-admission analysis showed Significant increases in SAR with diagnoses of cerebral palsy and inguinal hernia. Non-significant trend for increased SAR for all-hospital admission and first-hospital admission was found for some diagnoses. This study adds some reassurance to the neonatal and long-term child health of those born following ART. IVF children and those born following fresh embryo transfer may not be as healthy throughout childhood as their ICSI and frozen embryo transfer peers. Published concerns regarding neurological conditions and congenital abnormalities in children conceived using ART are supported by this study.