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Heart. 2018 Jun;104(11):945-948. doi: 10.1136/heartjnl-2017-312015. Epub 2017 Nov 16.

Cyanotic congenital heart disease following fertility treatments in the United States from 2011 to 2014.

Author information

1
Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA.
2
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA.
3
Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Eastern Virginia Medical School, Norfolk, Virginia, USA.
4
Department of Pediatrics, Section of Pediatric Cardiology, Stanford University School of Medicine, Palo Alto, California, USA.
5
Women's Health Hospital, Assiut University Hospitals, Assiut, Egypt.

Abstract

OBJECTIVE:

To examine the risk for cyanotic congenital heart diseases (CCHDs) among live births in the USA, resulting from various forms of infertility treatments.

METHODS:

This study is a cross-sectional analysis of live births in the USA from 2011 to 2014. Infertility treatments are categorised into two of the following groups on birth certificates: assisted reproductive technology (ART) fertility treatment (surgical egg removal; eg, in vitro fertilisation and gamete intrafallopian transfer) and non-ART fertility treatment (eg, medical treatment and intrauterine insemination). We compared the risk for CCHD in ART and non-ART fertility treatment groups with those infants whose mothers received no documented fertility treatment and were naturally conceived (NC).

RESULTS:

Among 14 242 267 live births from 2011 to 2014, a total of 101 494 live births were in the ART and 81 242 resulted from non-ART fertility treatments. CCHD prevalence in ART, non-ART and NC groups were 393/100 892 (0.39%), 210/80 884 (0.26%) and 10 749/14 020 749 (0.08%), respectively. As compared with naturally conceiving infants, risk for CCHD was significantly higher among infants born in ART (adjusted relative risk (aRR) 2.4, 95% CI 2.1 to 2.7) and non-ART fertility treatment groups (aRR 1.9, 95% CI 1.6 to 2.2). Absolute risk increase in CCHD due to ART and non-ART treatments were 0.03% and 0.02%,‚ÄČrespectively. A similar pattern was observed when the analysis was restricted to twins, newborns with birth weights under 1500 g and gestational age of less than 32 weeks.

CONCLUSIONS:

Our findings suggest an increased risk for CCHD in infants conceived after all types of infertility treatment.

KEYWORDS:

congenital heart disease; echocardiography; epidemiology

PMID:
29146625
DOI:
10.1136/heartjnl-2017-312015
[Indexed for MEDLINE]

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