TY - JOUR
T1 - General Health in a cohort of children conceived after assisted reproductive technology in the UK: a population-based record-linkage study
AU - Sutcliffe, Alastair G.
AU - Purkayastha, Mitana
AU - Brison, Daniel R.
AU - Nelson, Scott M.
AU - Roberts, Stephen A.
AU - Lawlor, Deborah A.
N1 - Funding Information:
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.
Funding Information:
This work was supported by the UK Medical Research Council (MRC) (grant number MR/L020335/1). D.A.L.’s contribution to the article was additionally supported by the University of Bristol and UK MRC via the MRC Integrative Epidemiology Unit (MC_UU_00011/1-6) and European Research Council (grant agreement: 101021566). The funders had no role in the study design, data collection, analyses, or interpretation of findings. Views expressed in this article are those of the authors and do not necessarily reflect the views of the funders.
Publisher Copyright:
© 2022 The Author(s)
PY - 2022/8/4
Y1 - 2022/8/4
N2 - 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.
AB - 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.
KW - assisted conception
KW - assisted reproductive technology
KW - cohort
KW - hospital admissions
KW - naturally conceived controls
KW - naturally conceived siblings
KW - record linkage
UR - https://doi.org/10.1016/j.ajog.2022.07.032
U2 - 10.1016/j.ajog.2022.07.032
DO - 10.1016/j.ajog.2022.07.032
M3 - Article
SN - 0002-9378
JO - American Journal of Obstetrics and Gynecology
JF - American Journal of Obstetrics and Gynecology
ER -