Assessing the impact of medically assisted reproduction on autism spectrum disorder risk.

IF 3.2 3区医学 Q2 GENETICS & HEREDITY

Journal of Assisted Reproduction and Genetics Pub Date : 2024-10-01 Epub Date: 2024-06-26 DOI:10.1007/s10815-024-03180-z

Omri Zamstein, Tamar Wainstock, Gil Gutvirtz, Eyal Sheiner

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Abstract

Purpose: Techniques of medically assisted reproduction interact with the embryo at crucial developmental stages, yet their impact on the fetus and subsequent child's health remains unclear. Given rising infertility rates and more frequent use of fertility treatments, we aimed to investigate if these methods heighten the risk of autism spectrum disorder (ASD) in children.

Methods: A population-based cohort study was conducted at Soroka University Medical Center, a tertiary referral hospital, encompassing singleton births. The incidence of ASD in offspring, incorporating either hospital or community-based diagnoses, was compared in relation to the conception method. To examine the cumulative incidence of ASD, a Kaplan-Meier survival curve was utilized. Cox proportional hazards model was employed to adjust for confounders.

Results: Among 115,081 pregnancies, 0.5% involved ovulation induction (OI) and 1.7% in vitro fertilization (IVF), with the rest conceived naturally. Fertility treatments were more common in older patients and linked to more diabetes, hypertensive disorders, preterm, and cesarean deliveries. Out of 767 ASD diagnoses, offspring from OI and IVF had higher initial ASD rates (2.1% and 1.3%) than natural conceptions (0.6%). In a Cox model accounting for maternal age, ethnicity, and gender, neither OI nor IVF was significantly associated with ASD. The adjusted hazard ratios were 0.83 (95% CI 0.48-1.43) for OI and 1.34 (95% CI 0.91-1.99) for IVF. When considering fertility treatments combined, the association with ASD remained non-significant (aHR 1.11, 95% CI 0.80-1.54, p = 0.52).

Conclusion: Fertility treatments, including OI and IVF, do not exhibit a significant association with heightened ASD risk in offspring.

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评估医学辅助生殖对自闭症谱系障碍风险的影响。

目的：医学辅助生殖技术会在胚胎的关键发育阶段与胚胎发生相互作用，但它们对胎儿和儿童健康的影响仍不清楚。鉴于不孕不育率的上升和生育治疗的频繁使用，我们旨在调查这些方法是否会增加儿童患自闭症谱系障碍（ASD）的风险：我们在索罗卡大学医学中心（一家三级转诊医院）开展了一项基于人群的队列研究，研究对象包括单胎婴儿。研究比较了医院或社区诊断结果与受孕方式之间的关系。为了研究 ASD 的累积发病率，采用了 Kaplan-Meier 生存曲线。采用考克斯比例危险模型调整混杂因素：在115 081例妊娠中，0.5%采用促排卵（OI），1.7%采用体外受精（IVF），其余均为自然受孕。高龄患者更常接受生育治疗，而且与糖尿病、高血压疾病、早产和剖腹产有关。在 767 例 ASD 诊断中，经人工授精和体外受精产生的后代的初始 ASD 率（2.1% 和 1.3%）高于自然受孕（0.6%）。在考虑了母亲年龄、种族和性别的考克斯模型中，卵巢早衰和体外受精均与 ASD 无明显关联。经调整的危险比分别为：自然受孕为 0.83（95% CI 0.48-1.43），体外受精为 1.34（95% CI 0.91-1.99）。如果将生育治疗合并考虑，则与 ASD 的关系仍然不显著（aHR 1.11，95% CI 0.80-1.54，p = 0.52）：结论：包括卵巢植入术和体外受精在内的生育治疗与后代ASD风险的增加并无显著关联。

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来源期刊

Journal of Assisted Reproduction and Genetics 医学-妇产科学

CiteScore

5.70

自引率

9.70%

发文量

286

审稿时长

1 months

期刊介绍： The Journal of Assisted Reproduction and Genetics publishes cellular, molecular, genetic, and epigenetic discoveries advancing our understanding of the biology and underlying mechanisms from gametogenesis to offspring health. Special emphasis is placed on the practice and evolution of assisted reproduction technologies (ARTs) with reference to the diagnosis and management of diseases affecting fertility. Our goal is to educate our readership in the translation of basic and clinical discoveries made from human or relevant animal models to the safe and efficacious practice of human ARTs. The scientific rigor and ethical standards embraced by the JARG editorial team ensures a broad international base of expertise guiding the marriage of contemporary clinical research paradigms with basic science discovery. JARG publishes original papers, minireviews, case reports, and opinion pieces often combined into special topic issues that will educate clinicians and scientists with interests in the mechanisms of human development that bear on the treatment of infertility and emerging innovations in human ARTs. The guiding principles of male and female reproductive health impacting pre- and post-conceptional viability and developmental potential are emphasized within the purview of human reproductive health in current and future generations of our species. The journal is published in cooperation with the American Society for Reproductive Medicine, an organization of more than 8,000 physicians, researchers, nurses, technicians and other professionals dedicated to advancing knowledge and expertise in reproductive biology.