Fertility treatments and gastrointestinal morbidity of the offspring.
Assisted reproductive technologies
Long term consequences
Pediatric gastrointestinal morbidity
Journal
Early human development
ISSN: 1872-6232
Titre abrégé: Early Hum Dev
Pays: Ireland
ID NLM: 7708381
Informations de publication
Date de publication:
05 2020
05 2020
Historique:
received:
28
01
2020
revised:
11
03
2020
accepted:
11
03
2020
pubmed:
30
3
2020
medline:
27
8
2021
entrez:
30
3
2020
Statut:
ppublish
Résumé
Prevalence of pregnancies conceived following fertility treatments is high worldwide. While the impact of fertility treatments on short-term perinatal outcome is well established, long-term consequences are yet to be determined. To study the association between mode of conception and long-term gastrointestinal morbidity among children born following fertility treatments. A population-based cohort analysis including all singleton deliveries occurring between 1991 and 2014 at a single regional tertiary medical center was performed. Fetuses with congenital malformations were excluded. A comparison was performed between children delivered following IVF, OI and spontaneous pregnancies. Hospitalizations up to the age of 18 years involving gastrointestinal morbidity were evaluated. Kaplan-Meier survival curve was used to compare cumulative morbidity incidence. A Cox regression model was used to control for confounders. During the study period 242,187 singleton deliveries met the inclusion criteria; 1.1% following IVF (n = 2603), and 0.7% following OI (n = 1721). Hospitalization rates involving gastrointestinal morbidity were significantly higher in children conceived following IVF and OI (5.7%, 7.1% respectively) as compared with children conceived spontaneously (5.4%; p = 0.005). The Kaplan-Meier survival curve demonstrated a significantly higher cumulative incidence of gastrointestinal morbidity following IVF and OI (log rank p = 0.001). Using a Cox proportional hazards model, controlling for maternal age, preterm delivery, birthweight, maternal diabetes and hypertensive disorders in pregnancy, IVF (adjusted HR = 1.27, CI 1.08-1.50, p = 0.004), was noted as an independent risk factor for long-term pediatric gastrointestinal morbidity. Singletons conceived by IVF appear to be at an increased risk for long-term gastrointestinal morbidity.
Sections du résumé
BACKGROUND
Prevalence of pregnancies conceived following fertility treatments is high worldwide. While the impact of fertility treatments on short-term perinatal outcome is well established, long-term consequences are yet to be determined.
OBJECTIVE
To study the association between mode of conception and long-term gastrointestinal morbidity among children born following fertility treatments.
STUDY DESIGN
A population-based cohort analysis including all singleton deliveries occurring between 1991 and 2014 at a single regional tertiary medical center was performed. Fetuses with congenital malformations were excluded. A comparison was performed between children delivered following IVF, OI and spontaneous pregnancies. Hospitalizations up to the age of 18 years involving gastrointestinal morbidity were evaluated. Kaplan-Meier survival curve was used to compare cumulative morbidity incidence. A Cox regression model was used to control for confounders.
RESULTS
During the study period 242,187 singleton deliveries met the inclusion criteria; 1.1% following IVF (n = 2603), and 0.7% following OI (n = 1721). Hospitalization rates involving gastrointestinal morbidity were significantly higher in children conceived following IVF and OI (5.7%, 7.1% respectively) as compared with children conceived spontaneously (5.4%; p = 0.005). The Kaplan-Meier survival curve demonstrated a significantly higher cumulative incidence of gastrointestinal morbidity following IVF and OI (log rank p = 0.001). Using a Cox proportional hazards model, controlling for maternal age, preterm delivery, birthweight, maternal diabetes and hypertensive disorders in pregnancy, IVF (adjusted HR = 1.27, CI 1.08-1.50, p = 0.004), was noted as an independent risk factor for long-term pediatric gastrointestinal morbidity.
CONCLUSION
Singletons conceived by IVF appear to be at an increased risk for long-term gastrointestinal morbidity.
Identifiants
pubmed: 32220768
pii: S0378-3782(20)30013-X
doi: 10.1016/j.earlhumdev.2020.105021
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
105021Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest No conflict of interests to declare. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.