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Assisted reproductive technology and long-term ophthalmic morbidity of the offspring

Published online by Cambridge University Press:  20 November 2020

Erez Tsumi ,
Yotam Lavy Open the ORCID record for Yotam Lavy [Opens in a new window] ,
Eyal Sheiner ,
Chiya Barrett ,
Avi Harlev ,
Maayan Hagbi Bal  and
Tamar Wainstock
Erez Tsumi*
Affiliation:
Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva84101, Israel
Yotam Lavy
Affiliation:
Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva84101, Israel
Eyal Sheiner
Affiliation:
Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva84101, Israel
Chiya Barrett
Affiliation:
Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva84101, Israel
Avi Harlev
Affiliation:
Fertility and IVF Unit, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva84101, Israel
Maayan Hagbi Bal
Affiliation:
Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva84101, Israel
Tamar Wainstock
Affiliation:
Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva84101, Israel
*
Address for correspondence: Erez Tsumi, Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion University, P.O.B. 151, Beer-Sheva84101, Israel. Email: [email protected]
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Abstract

In this study, we investigate if children born following assisted reproduction technologies (ARTs) are at an increased risk for long-term ophthalmic complications. For this purpose, a population-based cohort analysis was conducted which included all deliveries between 1991 and 2014 at a single tertiary medical center. Offspring were classified relative to conception method as ART or spontaneous pregnancies. Offspring hospitalizations up to the age of 18 years involving ophthalmic morbidities were evaluated according to a predefined set of ICD-9 codes. A Kaplan–Meier survival curve was used to compare cumulative hospitalization rates in exposed (ART) and unexposed offspring (spontaneous), and a Cox proportional hazards model was used to control for potential confounders. A total of 243,682 deliveries were included in the study. In that, 1.8% of the deliveries (4364) were of mothers who underwent fertility treatments and 98.2% (239,318) were conceived spontaneously. Offspring born to mothers who underwent fertility treatments had a significantly higher hospitalization rate involving ophthalmic morbidity, as compared to spontaneously conceived offspring (1.2% vs. 1.0%, p = 0.04). The Kaplan–Meier survival curve pointed to a significantly higher cumulative incidence of ophthalmic morbidity following ART (log rank p = 0.02). Cox proportional hazards model was adjusted for maternal age, preterm delivery, maternal hypertensive disorders, diabetes, and mode of delivery which demonstrated ART as an independent risk factor for long-term pediatric ophthalmic morbidity (adjusted hazard ratio = 1.37, CI 1.04–1.80, p-value = 0.02). We concluded that ART is an independent risk factor for long-term ophthalmic morbidity of the offspring.

Keywords

In vitro fertilizationintra-uterine inseminationassisted reproduction technologiespediatric ophthalmic morbidity
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 12 , Issue 4 , August 2021 , pp. 627 - 631
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Copyright
© The Author(s), 2020. Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease

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Footnotes

*

These two aforementioned authors have equally contributed to this article.

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