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IVF raises risk of developmental problems in premature infants, finds study

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f3404 (Published 24 May 2013) Cite this as: BMJ 2013;346:f3404
  1. Jaimini Sarkar
  1. 1Mumbai

An Australian study has found that very premature babies born after in vitro fertilisation (IVF) treatment are more likely to have some functional disability at ages 2 and 3 years than babies who were conceived naturally.

The researchers, from a number of medical institutions in Australia, looked at neurodevelopmental outcomes in 1473 infants who were born between 1998 and 2004 at less than 29 weeks’ gestation. Fifteen per cent (217) of these babies were born after assisted conception, either IVF or hyperovulation.

The researchers used assessment tools such as the Griffiths mental development scale and the Bayley scales to assess the children’s development when they were aged 2-3 years.

The results of a subgroup adjusted analysis showed that children born at between 22 and 26 weeks’ gestation and who were born after IVF were more likely than children who were conceived naturally to have severe functional disability such as cerebral palsy (unable to walk without aids), deafness (bilateral hearing aids or cochlear implant), or blindness (adjusted odds ratio 1.8 (95% confidence interval 1.1 to 3.1)).1 No such difference was shown in children born after 26 weeks’ gestation.

Mohamed Abdel-Latif, of the department of neonatology at the Centenary Hospital for Women and Children in Canberra and the study’s lead investigator, told the BMJ, “Previous studies showed that infants born after assisted conception have poorer neonatal outcomes and greater resource utilisation when compared with infants conceived spontaneously. The percentage of minor and major disabilities also continues to be controversial, hence we thought to investigate this issue further.

“The ideal gestation for birth is 38 weeks to 40 weeks. Birth before that and especially very preterm birth, like below 29 weeks’ gestation, may be associated with an increased risk of death and complications due to prematurity.

“Our findings showed that despite advances in medicine infants conceived by infertility treatment and born very early or preterm are at increased risk of disability. These infants need specialised follow-up by paediatricians so that abnormalities can be detected early and interventions like physiotherapy can be started if needed.”

He added, “In India the use of these technologies is increasing, and there are many centres specialising in this treatment. The success rate may vary from couple to couple and from one centre to another. It is essential that patients understand the entire process of IVF, including the financial cost, and be involved in decision making. After delivery they should arrange follow-up with their neonatologist or paediatrician, especially if their baby is born prematurely.”

Notes

Cite this as: BMJ 2013;346:f3404

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