Abstract
Objective
Studies have questioned the long-term health effects of offspring conceived following artificial reproductive technologies (ART). We aimed to evaluate whether an association exists between mode of conception (in-virto fertilization, IVF; ovulation induction, OI; or spontaneous) and neoplasm risk among the offspring followed for up to 18 years.
Study Design
A population based cohort analysis was performed, comparing the risk for neoplasms among children (up to the age of 18 years) based on mode of conception. Neoplasm diagnoses were based on hospital records of a single tertiary center in the region. All singleton infants born between the years 1991-2013 and discharged alive were included in the study. Infants with congenital malformations were excluded from the analysis. Kaplan-Meier survival curve was constructed to compare cumulative neoplasms incidence, and a Cox proportional hazard model was used to control for confounders, including gestational age, pregnancy complications and maternal factors.
Results
During the study period, 242 187 newborns met the inclusion criteria: 1160 (0.5%) were conceived following IVF treatment; 2853 (1.2%) following OI, and 23 817 (98.3%) were conceived spontaneously. During the follow up period (median 10.55 years), 1498 (0.6%) children were diagnosed with neoplasms (rates by neoplasm category are presented in the table). Incidence density rate for neoplasms was higher among both IVF and OI conceived children as compared to naturally conceived children: IVF 2.1/1000 person years (PY); OI 1.04/1000 PY; no treatment: 0.63/1000 PY (Kaplan-Meier Log rank p<0.001, figure). Controlling for confounders such as gestational diabetes, hypertensive disorders, preterm birth and maternal age, the association between ART and pediatric neoplasms remained significant (aHR 2.21; 95%CI 1.38-3.53 and aHR 1.70 95%CI 1.14-2.55 for IVF and OI, as compared to no treatment, respectively).
Conclusion
Children conceived following ART are at an increased risk for pediatric neoplasms.
Studies have questioned the long-term health effects of offspring conceived following artificial reproductive technologies (ART). We aimed to evaluate whether an association exists between mode of conception (in-virto fertilization, IVF; ovulation induction, OI; or spontaneous) and neoplasm risk among the offspring followed for up to 18 years.
Study Design
A population based cohort analysis was performed, comparing the risk for neoplasms among children (up to the age of 18 years) based on mode of conception. Neoplasm diagnoses were based on hospital records of a single tertiary center in the region. All singleton infants born between the years 1991-2013 and discharged alive were included in the study. Infants with congenital malformations were excluded from the analysis. Kaplan-Meier survival curve was constructed to compare cumulative neoplasms incidence, and a Cox proportional hazard model was used to control for confounders, including gestational age, pregnancy complications and maternal factors.
Results
During the study period, 242 187 newborns met the inclusion criteria: 1160 (0.5%) were conceived following IVF treatment; 2853 (1.2%) following OI, and 23 817 (98.3%) were conceived spontaneously. During the follow up period (median 10.55 years), 1498 (0.6%) children were diagnosed with neoplasms (rates by neoplasm category are presented in the table). Incidence density rate for neoplasms was higher among both IVF and OI conceived children as compared to naturally conceived children: IVF 2.1/1000 person years (PY); OI 1.04/1000 PY; no treatment: 0.63/1000 PY (Kaplan-Meier Log rank p<0.001, figure). Controlling for confounders such as gestational diabetes, hypertensive disorders, preterm birth and maternal age, the association between ART and pediatric neoplasms remained significant (aHR 2.21; 95%CI 1.38-3.53 and aHR 1.70 95%CI 1.14-2.55 for IVF and OI, as compared to no treatment, respectively).
Conclusion
Children conceived following ART are at an increased risk for pediatric neoplasms.
| Original language | American English |
|---|---|
| Pages (from-to) | S46-S46 |
| Journal | American Journal of Obstetrics and Gynecology |
| Volume | 216 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2017 |