Examining Infertility Treatment and Early Childhood Development in the Upstate KIDS Study

Parental Obesity and Early Childhood Development

“…It remains possible that reporting errors may be higher for paternal BMI, as it was ascertained from mothers. Although there was loss to follow-up, 29 generalized linear mixed effects models are robust to such losses under the missing at random assumption. 34 Our population, which was predominantly non-Hispanic white and highly educated, may not be generalizable to all populations, but the prevalence of obesity in the cohort was comparable with national data.…”

“…We did not adjust for infertility treatment because we previously did not identify associations. 29 Fish oil supplementation, multivitamin use, and the Townsend index were added in separate models but did not alter associations and were not retained in final statistical models (data not shown). Multiple imputations completed missing data on paternal BMI (11%), marital status (n = 4%), fish oil (3%), multivitamin use (3%), parity (n <1%), drinking (n <1%), smoking (n <1%), and insurance status (n <1%).…”

“…28,29 The ASQ encourages parents to perform activities with their children and then respond to questions capturing 5 developmental domains (ie, fine motor, gross motor, communication, personal-social functioning, and problem-solving ability). Parents completed the ASQ at 4 to 6,8,12,18,24,30, and 36 months of age, corrected for gestational age.…”

“…30,31 Parents were contacted to administer a follow-up screen for any failed domain(s) by using an age-appropriate ASQ as recommended by the instrument. 29 The child was considered to have failed the domain only if she or he also failed the follow-up screen or if the parent was not reachable. Screening instruments were considered valid only if completed in the specified age windows.…”

Neurodevelopmental Outcomes After Assisted Reproductive Technologies

“…1,5 Although the short-term perinatal outcomes after ART are well established, longterm neurodevelopmental outcomes, including cognitive, motor, and language development, are still a source of controversy. 3,[6][7][8][9] A review from the National Institutes of Health recognized that "lingering data gaps [exist] in the equivocal literature for many neurodevelopmental disabilities relative to ART" and that "…cohorts with longitudinal assessment…of neurodevelopment…are paramount for the development of empirically-based guidance…." 10 Similarly, the largest systematic review of more than 80 studies addressing long-term neurodevelopment after ART concluded that additional data were required to determine the true effect of fertility treatments on these outcomes.…”