Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-26T23:52:12.861Z Has data issue: false hasContentIssue false
  • English
  • Français

Assisted conception and the risk of CHD: a case–control study

Published online by Cambridge University Press:  26 May 2016

Susie J. Schofield ,
Victoria L. Doughty ,
Nicole van Stiphout ,
Rodney C. G. Franklin ,
Mark R. Johnson ,
Piers E. F. Daubeney  and
Paul Cullinan
Susie J. Schofield*
Affiliation:
Occupational and Environmental Medicine, Imperial College (NHLI), London, United Kingdom Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom
Victoria L. Doughty
Affiliation:
Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom
Nicole van Stiphout
Affiliation:
Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom
Rodney C. G. Franklin
Affiliation:
Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom
Mark R. Johnson
Affiliation:
Chelsea and Westminster Hospital, Imperial College, London, United Kingdom
Piers E. F. Daubeney
Affiliation:
Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom Chelsea and Westminster Hospital, Imperial College, London, United Kingdom National Heart and Lung Institute, Imperial College, London, United Kingdom
Paul Cullinan
Affiliation:
Occupational and Environmental Medicine, Imperial College (NHLI), London, United Kingdom Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom
*
Correspondence to: Ms S. J. Schofield, Department of Occupational and Environmental Medicine, Imperial College (National Heart and Lung Institute), Emmanuel Kaye Building, 1b Manresa Road, London SW3 6LR, United Kingdom. Tel: 020 759 47964; Fax: 0207 351 8336; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Epidemiological studies suggest a higher prevalence of congenital malformations in children conceived through assisted reproductive technologies. There are a few studies that address CHD specifically and most have examined data from registries. We examined the relationship between CHD and assisted conception using data collected in a specialist paediatric cardiac service in the United Kingdom.

Between April, 2010 and July, 2011, the parents of children attending paediatric cardiology clinics at the Royal Brompton Hospital, London, were invited to complete a questionnaire that enquired about the nature of their child’s conception, the route for their original referral, and a number of potential confounding exposures. “Cases” were defined as children diagnosed with one or more carefully defined CHDs and “controls” as those with normal hearts.

Of 894 new attendees with complete data, half of them were cases (n=410, 45.9%). The overall prevalence of assisted conception was 5.4% (n=44). Logistic regression analysis demonstrated a non-significant increase in the crude odds for the use of assisted reproduction (odds ratio 1.21, 95% confidence interval 0.66–2.22) in this group. After adjustment for gestation, parity, year of birth, and maternal age, the odds ratio reduced (odds ratio 0.95, 95% confidence interval 0.48–1.88). Increased rates of assisted conception were observed in a number of CHD subgroups, although no significant differences were found.

These findings do not suggest an overall association between CHD and assisted reproduction in this population.

Keywords

Heart defectscongenitalassisted reproductive technologiesovulation inductionin vitro fertilisation
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 3 , March 2017 , pp. 473 - 479
Check for updates
Copyright
© Cambridge University Press 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

Joint last authors.

References

1. HFEA. Fertility treatment in 2010: trends and figures. 2011.Google Scholar
2. Barlow, DH. The children of assisted reproduction – the need for an ongoing debate. Hum Reprod 2002; 17: 1133–1134.CrossRefGoogle ScholarPubMed
3. Schieve, LA, Rasmussen, SA, Reefhuis, J. Risk of birth defects among children conceived with assisted reproductive technology: providing an epidemiologic context to the data. Fertil Steril 2005; 84: 1320–1324.Google Scholar
4. Zhu, JL, Basso, O, Obel, C, Bille, C, Olsen, J. Infertility, infertility treatment, and congenital malformations: Danish national birth cohort. BMJ 2006; 333: 679.Google Scholar
5. Rimm, AA, Katayama, AC, Katayama, KP. A meta-analysis of the impact of IVF and ICSI on major malformations after adjusting for the effect of subfertility. J Assist Reprod Genet 2011; 28: 699–705.CrossRefGoogle ScholarPubMed
6. Tararbit, K, Houyel, L, Bonnet, D, et al. Risk of congenital heart defects associated with assisted reproductive technologies: a population-based evaluation. Eur Heart J 2011; 32: 500–508.CrossRefGoogle ScholarPubMed
7. Reefhuis, J, Honein, MA, Schieve, LA, Correa, A, Hobbs, CA, Rasmussen, SA. Assisted reproductive technology and major structural birth defects in the United States. Hum Reprod 2009; 24: 360–366.Google Scholar
8. Davies, MJ, Moore, VM, Willson, KJ, et al. Reproductive technologies and the risk of birth defects. N Engl J Med 2012; 366: 1803–1813.CrossRefGoogle ScholarPubMed
9. Olson, CK, Keppler-Noreuil, KM, Romitti, PA, et al. In vitro fertilization is associated with an increase in major birth defects. Fertil Steril 2005; 84: 1308–1315.Google Scholar
10. Koivurova, S, Hartikainen, AL, Gissler, M, Hemminki, E, Sovio, U, Jarvelin, MR. Neonatal outcome and congenital malformations in children born after in-vitro fertilization. Hum Reprod 2002; 17: 1391–1398.Google Scholar
11. Anthony, S, Buitendijk, SE, Dorrepaal, CA, Lindner, K, Braat, DD, den Ouden, AL. Congenital malformations in 4224 children conceived after IVF. Hum Reprod 2002; 17: 2089–2095.Google Scholar
12. Kallen, B, Finnstrom, O, Nygren, KG, Olausson, PO. In vitro fertilization (IVF) in Sweden: risk for congenital malformations after different IVF methods. Birth Defects Res A Clin Mol Teratol 2005; 73: 162–169.Google Scholar
13. Klemetti, R, Gissler, M, Sevon, T, Koivurova, S, Ritvanen, A, Hemminki, E. Children born after assisted fertilization have an increased rate of major congenital anomalies. Fertil Steril 2005; 84: 1300–1307.Google Scholar
14. Hansen, M, Kurinczuk, JJ, Bower, C, Webb, S. The risk of major birth defects after intracytoplasmic sperm injection and in vitro fertilization. N Engl J Med 2002; 346: 725–730.Google Scholar
15. Bonduelle, M, Wennerholm, UB, Loft, A, et al. A multi-centre cohort study of the physical health of 5-year-old children conceived after intracytoplasmic sperm injection, in vitro fertilization and natural conception. Hum Reprod 2005; 20: 413–419.CrossRefGoogle ScholarPubMed
16. El-Chaar, D, Yang, Q, Gao, J, et al. Risk of birth defects increased in pregnancies conceived by assisted human reproduction. Fertil Steril 2009; 92: 1557–1561.Google Scholar
17. Wren, C, Richmond, S, Donaldson, L. Temporal variability in birth prevalence of cardiovascular malformations. Heart 2000; 83: 414–419.Google Scholar
18. Brown, KL, Crowe, S, Pagel, C, et al. Use of diagnostic information submitted to the United Kingdom Central Cardiac Audit Database: development of categorisation and allocation algorithms. Cardiol Young 2013; 23: 491–498.Google Scholar
19. Office of Womens Health. http://www.womenshealth.gov/publications/our-publications/fact-sheet/infertility.html. February 2016.Google Scholar
20. United Kingdom Standard Occupational Classification 2000. http://www.ons.gov.uk/ons/guide-method/classifications/archived-standard-classifications/standard-occupational-classification-2000/index.html. October 2011.Google Scholar
21. Hunter, S, Heads, A, Wyllie, J, Robson, S. Prenatal diagnosis of congenital heart disease in the northern region of England: benefits of a training programme for obstetric ultrasonographers. Heart 2000; 84: 294–298.Google Scholar
22. Wren, C, Reinhardt, Z, Khawaja, K. Twenty-year trends in diagnosis of life-threatening neonatal cardiovascular malformations. Arch Dis Child Fetal Neonatal Ed 2008; 93: F33–F35.Google Scholar