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Assisted reproductive technology and birth defects in a Chinese birth cohort study

BACKGROUND: It has been consistently shown in several meta-analyses that infants born after ART have an excess of birth defects compared with those after spontaneous conception, however, the prevalence of birth defects among ART offspring in China is incompletely studied. Moreover, it is unclear to...

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Autores principales: Lv, Hong, Diao, Feiyang, Du, Jiangbo, Chen, Ting, Meng, Qingxia, Ling, Xiufeng, Li, Hong, Song, Ci, Xi, Qi, Jiang, Yangqian, Xu, Yan, Tao, Shiyao, Huang, Lei, Wen, Mingyang, Peng, Meijuan, Liu, Cong, Lu, Qun, He, Yuanlin, Yin, Yin, Liu, Xiaoyu, Xu, Bo, Han, Xiumei, Zhou, Kun, Jiang, Tao, Zhao, Yang, Ma, Hongxia, Jin, Guangfu, Xia, Yankai, Liu, Jiayin, Lin, Yuan, Hu, Zhibin, Shen, Hongbing
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8315325/
https://www.ncbi.nlm.nih.gov/pubmed/34327418
http://dx.doi.org/10.1016/j.lanwpc.2020.100090
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author Lv, Hong
Diao, Feiyang
Du, Jiangbo
Chen, Ting
Meng, Qingxia
Ling, Xiufeng
Li, Hong
Song, Ci
Xi, Qi
Jiang, Yangqian
Xu, Yan
Tao, Shiyao
Huang, Lei
Wen, Mingyang
Peng, Meijuan
Liu, Cong
Lu, Qun
He, Yuanlin
Yin, Yin
Liu, Xiaoyu
Xu, Bo
Han, Xiumei
Zhou, Kun
Jiang, Tao
Zhao, Yang
Ma, Hongxia
Jin, Guangfu
Xia, Yankai
Liu, Jiayin
Lin, Yuan
Hu, Zhibin
Shen, Hongbing
author_facet Lv, Hong
Diao, Feiyang
Du, Jiangbo
Chen, Ting
Meng, Qingxia
Ling, Xiufeng
Li, Hong
Song, Ci
Xi, Qi
Jiang, Yangqian
Xu, Yan
Tao, Shiyao
Huang, Lei
Wen, Mingyang
Peng, Meijuan
Liu, Cong
Lu, Qun
He, Yuanlin
Yin, Yin
Liu, Xiaoyu
Xu, Bo
Han, Xiumei
Zhou, Kun
Jiang, Tao
Zhao, Yang
Ma, Hongxia
Jin, Guangfu
Xia, Yankai
Liu, Jiayin
Lin, Yuan
Hu, Zhibin
Shen, Hongbing
author_sort Lv, Hong
collection PubMed
description BACKGROUND: It has been consistently shown in several meta-analyses that infants born after ART have an excess of birth defects compared with those after spontaneous conception, however, the prevalence of birth defects among ART offspring in China is incompletely studied. Moreover, it is unclear to what extent the risk of birth defects is associated with parental infertility characteristics, specific ART procedures and twinning. METHODS: In the prospective cohort study, we included women who participated in the cohort, and had pregnancies of at least 20 gestational weeks between August 2016 and May 2019, and followed them until their children reached 1 year of age. Exposures of interest were ART, as well as infertility-related characteristics, certain ART procedures and specific medication usage. The primary outcome was birth defects including both major and minor defects, which we analysed with logistic generalized estimating equations to investigate the association with ART and certain ART characteristics. FINDINGS: A total of 1,825 women with ART-pregnancy and 3,483 women with spontaneous-pregnancy were included in the analysis. The prevalence of any defects was significantly higher among ART-births than their non-ART counterparts at each follow-up, specifically at prenatal screening (2•2% vs. 1•2%), at delivery (4•9% vs. 2•9%), at 6 months (10•4% vs. 5•3%) and 1 year of age (13•9% vs. 7•0%), and the associations between ART and increased risk of birth defects at each follow-up were similarly robust. Among ART-births, GnRH antagonist regimen for ovulation induction in women was associated with an increased risk of birth defects in their offspring after taking into account potential influencing factors (Multivariable model: adjusted risk ratio [aRR] 1•47, 1•04–2•07). Additionally, mediation through twinning accounted for 31•1% of the risk of ART-associated birth defects. INTERPRETATION: The results suggest that ART confers an increased risk for birth defects in offspring. The risk is partly attributable to infertility characteristics, certain ovulation induction regimen, and to some extent mediated by twinning. Our findings highlight the importance of long-term follow-up of children conceived via ART for health conditions. FUNDING: National Key Research and Development Program of China, National Natural Science Foundation of China and Natural Science Foundation of Jiangsu Province.
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spelling pubmed-83153252021-07-28 Assisted reproductive technology and birth defects in a Chinese birth cohort study Lv, Hong Diao, Feiyang Du, Jiangbo Chen, Ting Meng, Qingxia Ling, Xiufeng Li, Hong Song, Ci Xi, Qi Jiang, Yangqian Xu, Yan Tao, Shiyao Huang, Lei Wen, Mingyang Peng, Meijuan Liu, Cong Lu, Qun He, Yuanlin Yin, Yin Liu, Xiaoyu Xu, Bo Han, Xiumei Zhou, Kun Jiang, Tao Zhao, Yang Ma, Hongxia Jin, Guangfu Xia, Yankai Liu, Jiayin Lin, Yuan Hu, Zhibin Shen, Hongbing Lancet Reg Health West Pac Research Paper BACKGROUND: It has been consistently shown in several meta-analyses that infants born after ART have an excess of birth defects compared with those after spontaneous conception, however, the prevalence of birth defects among ART offspring in China is incompletely studied. Moreover, it is unclear to what extent the risk of birth defects is associated with parental infertility characteristics, specific ART procedures and twinning. METHODS: In the prospective cohort study, we included women who participated in the cohort, and had pregnancies of at least 20 gestational weeks between August 2016 and May 2019, and followed them until their children reached 1 year of age. Exposures of interest were ART, as well as infertility-related characteristics, certain ART procedures and specific medication usage. The primary outcome was birth defects including both major and minor defects, which we analysed with logistic generalized estimating equations to investigate the association with ART and certain ART characteristics. FINDINGS: A total of 1,825 women with ART-pregnancy and 3,483 women with spontaneous-pregnancy were included in the analysis. The prevalence of any defects was significantly higher among ART-births than their non-ART counterparts at each follow-up, specifically at prenatal screening (2•2% vs. 1•2%), at delivery (4•9% vs. 2•9%), at 6 months (10•4% vs. 5•3%) and 1 year of age (13•9% vs. 7•0%), and the associations between ART and increased risk of birth defects at each follow-up were similarly robust. Among ART-births, GnRH antagonist regimen for ovulation induction in women was associated with an increased risk of birth defects in their offspring after taking into account potential influencing factors (Multivariable model: adjusted risk ratio [aRR] 1•47, 1•04–2•07). Additionally, mediation through twinning accounted for 31•1% of the risk of ART-associated birth defects. INTERPRETATION: The results suggest that ART confers an increased risk for birth defects in offspring. The risk is partly attributable to infertility characteristics, certain ovulation induction regimen, and to some extent mediated by twinning. Our findings highlight the importance of long-term follow-up of children conceived via ART for health conditions. FUNDING: National Key Research and Development Program of China, National Natural Science Foundation of China and Natural Science Foundation of Jiangsu Province. Elsevier 2021-01-22 /pmc/articles/PMC8315325/ /pubmed/34327418 http://dx.doi.org/10.1016/j.lanwpc.2020.100090 Text en © 2020 The Author(s). Published by Elsevier Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Research Paper
Lv, Hong
Diao, Feiyang
Du, Jiangbo
Chen, Ting
Meng, Qingxia
Ling, Xiufeng
Li, Hong
Song, Ci
Xi, Qi
Jiang, Yangqian
Xu, Yan
Tao, Shiyao
Huang, Lei
Wen, Mingyang
Peng, Meijuan
Liu, Cong
Lu, Qun
He, Yuanlin
Yin, Yin
Liu, Xiaoyu
Xu, Bo
Han, Xiumei
Zhou, Kun
Jiang, Tao
Zhao, Yang
Ma, Hongxia
Jin, Guangfu
Xia, Yankai
Liu, Jiayin
Lin, Yuan
Hu, Zhibin
Shen, Hongbing
Assisted reproductive technology and birth defects in a Chinese birth cohort study
title Assisted reproductive technology and birth defects in a Chinese birth cohort study
title_full Assisted reproductive technology and birth defects in a Chinese birth cohort study
title_fullStr Assisted reproductive technology and birth defects in a Chinese birth cohort study
title_full_unstemmed Assisted reproductive technology and birth defects in a Chinese birth cohort study
title_short Assisted reproductive technology and birth defects in a Chinese birth cohort study
title_sort assisted reproductive technology and birth defects in a chinese birth cohort study
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8315325/
https://www.ncbi.nlm.nih.gov/pubmed/34327418
http://dx.doi.org/10.1016/j.lanwpc.2020.100090
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