Long-Term Cardiovascular Morbidity in Children following Assisted Reproductive Technology (ART) Pregnancies Compared to Spontaneous Pregnancies - Israeli Fertility Association Conference-Ayala 2017, May 8-9, 2017

Avi Harlev ¹ Tamar Wainstock ² Asnat Walfisch ³ Idit Segal ⁴ Eliahu Levitas ¹ Daniella Landau ⁵ Eyal Sheiner ³

¹Fertility and IVF Unit, Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben Gurion University of the Negev
²Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev
³High Risk Pregnancy, Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben Gurion University of the Negev
⁴Israeli, Ministry of Health
⁵Department of Neonatology, Soroka University Medical Center, Ben Gurion University of the Negev

Introduction: Fertility treatments are a risk factor for congenital anomalies. The impact of ART on long term morbidity of the offspring is debatable.

Aim: To determine the risk of long-term cardiovascular morbidity among children born following in-vitro fertilization (IVF) and ovulation induction (OI) as compared with spontaneous pregnancies.

Materials & Methods: A population-based cohort study including all singleton deliveries between the years 1991-2013 was performed. Fetuses with congenital malformations were excluded. Children delivered following pregnancies achieved by IVF, OI and spontaneous pregnancies were compared. Hospitalizations up to the age of 18 years involving cardiovascular morbidity were evaluated. Cardiovascular morbidities assessed included valvular disorders, hypertension, arrhythmias, rheumatic fever, cardiomyopathy, ischemic heart disease, pulmonary heart disease, endocarditis, heart failure, etc. Kaplan-Meier survival curve was used to compare cumulative morbidity incidence. A Cox regression model was used to control for confounders.

Results: During the study period 242,187singleton deliveries met the inclusion criteria; 1.1% following IVF (n=2603), and 0.7% occurred following OI (n=1721). Hospitalizations up to the age of 18 years involving cardiovascular morbidity (n=1503) were comparable in children delivered following IVF (0.6%), OI (0.7%) and spontaneous pregnancies (0.6%; p=0.88). No significant difference in the cumulative incidence of cardiovascular morbidity was noted between the groups. Using a regression model controlling for maternal age, preterm delivery, birth weight, maternal diabetes, and hypertensive disorders, both IVF and OI were not noted as a risk factor for long-term pediatric cardiovascular morbidity (adjusted HR=1.12, CI 95% 0.67-1.87, p=0.647, adjusted HR=0.94, CI 95% 0.53-1.67, p=0.857 respectively).

Conclusion: Singletons conceived using ART are not at an increased risk of long-term pediatric cardiovascular morbidity.