Cerebral palsy after assisted reproductive technology: a cohort study

Abstract

ARTAssisted reproductive technology IVF In vitro fertilization AIM To calculate the birth prevalence of cerebral palsy (CP) after assisted reproductive technology (ART) and compare the clinical outcomes of children with CP after ART or natural conception.

The continually changing epidemiology of cerebral palsy

“…The pathway to CP for those who also received ART was thought to be accounted for by plurality (multiple embryo transfer) and being born very premature. But a very recent paper identified an excess risk in those born as singletons and very premature . In this paper with more recent birth years, the proportion of CP following ART remained the same at 5.6%, but there were only 2 of 11 children born less than 31 weeks, and only three of 11 were multiples, suggesting even a changing panorama of CP following ART.…”

Cerebral palsy after in vitro fertilization

“…The paper by Goldsmith et al . links assisted reproductive techniques to an increased risk of cerebral palsy (CP), an association which has previously been demonstrated in other large studies.…”

“…The epidemiological study of this problem necessitates access to population data on CP in the population. In the Goldsmith et al . study, this is guaranteed by the presence of a high quality CP register; such registers have also been used in previous studies .…”

Short‐ and long‐term outcomes in children born after assisted reproductive technology

“…Furthermore, the risk of cerebral palsy was significantly higher in twins conceived by ART than that of singletons conceived by ART . By adjusting for preterm birth, the risk of cerebral palsy in ART twins diminished; however, preterm birth should be considered as a mediator and not a confounding factor on the causal pathway of ART twins and neurodevelopmental outcomes …”

“…8 Furthermore, the risk of cerebral palsy was significantly higher in twins conceived by ART than that of singletons conceived by ART. 9 By adjusting for preterm birth, the risk of cerebral palsy in ART twins diminished; however, preterm birth should be considered as a mediator and not a confounding factor on the causal pathway of ART twins and neurodevelopmental outcomes. 9 Although the UK, the Netherlands, Belgium, and the Nordic countries have successfully reduced multiple births after ART, the rest of Europe, China, and the USA have made little progress on reducing multiple pregnancies.…”