Cerebral Palsy, Autism Spectrum Disorders, and Developmental Delay in Children Born After Assisted Conception

Abstract

To assess the existing evidence of associations between assisted conception and cerebral palsy (CP), autism spectrum disorders (ASD), and developmental delay. Data Sources: Forty-one studies identified in a systematical PubMed and Excerpta Medica Database (EMBASE) search for articles published from January 1, 1996, to April 1, 2008. Study Selection: Studies written in English comparing children born after assisted conception with children born after natural conception assessing CP, ASD, and developmental delay, based on original data with a follow-up of 1 year or more. Main Exposures: In vitro fertilization (IVF) with or without intracytoplasmic sperm injection or ovulation induction with or without subsequent intrauterine insemination. Main Outcome Measures: Cerebral palsy, ASD, and developmental delay. Results: Nine CP studies showed that children born after IVF had an increased risk of CP associated with preterm delivery. In our meta-analysis including 19 462 children exposed to IVF, we estimated a crude odds ratio of 2.18 (95% confidence interval, 1.71-2.77). Eight ASD studies and 30 studies on developmental delay showed inconsistent results. No studies assessed the risk of CP, ASD, or developmental delay in children born after ovulation induction exclusively.

Cerebral palsy after assisted reproductive technology: a cohort study

“…[4][5][6] ART is reported to double the risk of CP overall. 7 This is likely related to the increased proportions of preterm and multiple births, both risk factors for CP. 1 However, there is variation across studies regarding singletons, who comprise 88% of all cases of CP in Australia.…”

“…1 However, there is variation across studies regarding singletons, who comprise 88% of all cases of CP in Australia. 1 Some studies report that the risk of CP is doubled for singletons born after in vitro fertilization (IVF), 7,8 while others have found no increased risk in this group. [9][10][11] The risk of CP for multiple births is well established and studies have reported that ART conception does not further increase risk.…”

“…[9][10][11] The risk of CP for multiple births is well established and studies have reported that ART conception does not further increase risk. 7,8,10,11 A small number of studies have included subgroup analyses of unlike sex twins, to account for the lower proportion of ART monochorionic twins, and this has generally not altered their conclusions. [11][12][13] The majority of research regarding ART and CP has emerged from Scandinavia; however, care must be taken when generalizing research findings to regions where demographics, socioeconomics, health care, and ART practices differ.…”

Assessing the Risk of Cerebral Palsy in Children Born after Assisted Conception – The Role of Multiple Pregnancy and Preterm Delivery / Procena rizika od cerebralne paralize kod dece začete vantelesnim oplođenjem – uloga višestruke trudnoće i prevremenog rođenja

“…Some studies (10,18,21) reported an association between assisted conception and CP, whereas others could not demonstrate such statistical significance (6,14,32). According to the regression analysis, the risk of CP in IVF children is largely attributed to a high proportion of multiple pregnancies, low birth weight, and prematurity in this population (6,14,21,25,41). The selected studies showed inconsistent findings as some found an association between CP and IVF singletons (18,21) and others did not (6,14,25,27,34).…”

“…Therefore, assessment of the risk of neurodevelopmental disorders at older ages, such as dyslexia or fine manipulative dyspraxia was excluded. In systematic review published by Hvidtjørn et al (41), the main focus was on the assessing of associations between ART and CP. This study was based on the original data and articles published from January 1, 1996 to April 1, 2008 with a follow-up of 1 year or more.…”