Congenital malformations in children conceived by assisted reproductive technologies in Kazakhstan: A prospective cohort study
DOI:
https://doi.org/10.37800/RM.4.2023.76-85Keywords:
infertility, assisted reproductive technologies (ART), in vitro fertilization (IVF), offspring health, congenital malformations, congenital cardiovascular malformationsAbstract
Relevance: The growing popularity of assisted reproductive technologies (ART) has necessitated research in the field of health and development of children conceived using these technologies. One important aspect of such research is the study of the frequency of congenital malformations in ART children.
The study aimed to assess the risks of increasing congenital malformations in children conceived by ART.
Materials and Methods: A prospective cohort study was conducted as part of the Scientific Project ИРН AP14872103, «Somatic and psychosocial status of children after ART determination with the development of prediction model and principles of child management.» The study included 252 children under 5 years, of whom 120 were conceived through ART. Both groups had their medical history collected, and the children were examined and consulted with a pediatrician. We used adjusted odds ratios (OR) to compare the results with the control group and analyze maternal risk factors.
Results: The frequency of congenital malformations was statistically significantly lower in the study group (p=0.026). The odds of giving birth to children with congenital malformations using ART were 2.7 times lower than naturally conceived (NC) children (95% CI: 0.15-0.91). Interestingly, the odds of giving birth to children with cardiovascular abnormalities were 2.06 times higher when using ART compared to NC (95% CI: 0.98-4.29). However, these findings were not statistically significant (p=0.052). Analysis of risk factors for congenital heart disease in ART offspring revealed that factors such as multiple pregnancies, cholelithiasis, ectopic pregnancies, and a history of using ART increased the risks of congenital cardiac anomalies. In contrast, the use of intracytoplasmic sperm injection (ICSI) and progesterone supplementation during pregnancy reduced this risk.
Conclusion: Considering that more than 10 million children have already been born worldwide through ART, the possibility of reducing the risks of congenital malformations through modern technologies is promising. Furthermore, the cohort study of children in Kazakhstan will help increase the sample size and extend the applicability of the findings to other ethnic groups, thereby contributing to the analysis of data at a global level.
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