Assisted Reproduction and Child Health: Risk of Birth Defects, Mortality, and Effect on Grade School Performance

辅助生殖和儿童健康：出生缺陷、死亡率的风险以及对小学成绩的影响

• 批准号: 9979895
• 负责人: BARBARA Joan LUKE
• 金额: $ 48.6万
• 依托单位: MICHIGAN STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-30 至 2022-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9979895
• 关键词: 2 year old; Accounting; Affect; Age; Artificial Insemination; Assisted Reproductive Technology; Biology; Birth; Birth Certificates; Birth Rate; Caring; Characteristics; Child; Child Health; Childbirth; Conceptions; Congenital Abnormality; Control Groups; Couples; Data; Fertilization in Vitro; First Births; Growth; Hospital Costs; Hospitalization; Infant; Infant Mortality; Infertility; Intracytoplasmic Sperm Injections; Knowledge; Link; Live Birth; Malignant Childhood Neoplasm; Massachusetts; Maternal Age; Maternal Educational Status; Medical; Methods; New York; North Carolina; Oocytes; Outcome; Ovulation Induction; Pediatric Hospitals; Performance; Perinatal; Population Study; Process; Quadruplet Multiple Birth; Registries; Reporting; Risk; Sample Size; Sampling; Schools; Seminal fluid; Services; Siblings; Small for Gestational Age Infant; Societies; Special Education; Surveillance Methods; Testing; Texas; Treatment Factor; Triplet Multiple Birth; Twin Multiple Birth; United States; Woman; adverse outcome; assisted reproduction; base; elementary school; follow-up; high risk; improved; infertility treatment; intrauterine insemination; mental development; mortality; mortality risk; neoplasm registry; premature; reproductive; subfertility; technology/technique; treatment comparison

It is estimated that about 12% of reproductive age women in the United States have ever sought medical care for infertility. Assisted reproductive technology (ART) includes all infertility treatments to achieve conception; in vitro fertilization (IVF) is the process by which an oocyte is fertilized by semen outside the body; non-IVF ART treatments include ovulation induction, artificial insemination, and intrauterine insemination. In 2013 in the United States, there were nearly 68,000 babies born from IVF, accounting for 1.7% of all births, a proportion which has doubled over the past decade. To date, there has not been a population-based study of ART and IVF in the United States linking data on ART treatments, birth outcomes, registry-confirmed birth defects, and school performance. With this proposed study we seek to fill this knowledge gap. The purpose of this study is to evaluate the risk of mortality, birth defects, and effect on grade school performance among children conceived through IVF and ART, their siblings, and controls in New York, Texas, Massachusetts, and North Carolina. This proposed study will be based on births from 2004-18, and will include an estimated 163,000 IVF children, 41,000 IVF siblings, and 1,250,000 non-IVF control children. Overall Specific Aim: To compare the rates of birth defects and mortality, and effect on school performance among children conceived with IVF, non-IVF ART, and spontaneously, including siblings. Hypothesis 1: Children born from IVF have higher risks for birth defects than the control group; the risk varies by treatments and parental characteristics. Primary Aims:1) To test whether the risk of birth defects in IVF and non-IVF ART births are higher than in spontaneously-conceived births; 2) To identify parental factors affecting risk within each group; 3) In the IVF group, to identify treatment factors that affect the risk. Hypothesis 2: Children born from IVF have higher risks of death compared to their siblings and non-IVF Control children, primarily due to plurality status (greater likelihood of being conceived as a twin, triplet, or quadruplet, but born as a singleton; or of having been born a twin, triplet, or quadruplet) and associated excess of growth restriction (small-for-gestational age) and prematurity. This greater perinatally-related mortality risk is hypothesized to be nonsignificant by two years of age, and varies by infertility treatments and parental factors (particularly reduced with older maternal age at delivery and higher maternal educational status). Hypothesis 3: Children born from IVF have greater risks of poorer educational performance and are more likely to need special education services compared to their siblings and non-IVF Control children, primarily due to their plurality status (greater likelihood of being conceived as a twin, triplet, or quadruplet, but born as a singleton; or of having been born a twin, triplet, or quadruplet) and the associated excess of growth restriction (small-for-gestational age) and prematurity. This greater perinatally-related educational risk varies by infertility treatments and parental factors (particularly reduced with older maternal age at delivery and higher maternal educational status).

据估计，美国约有12%的育龄妇女曾经求医 治疗不孕症辅助生殖技术（ART）包括所有不孕症治疗，以实现概念; 体外受精（IVF）是卵母细胞在体外通过精液受精的过程;非IVF ART 治疗方法包括诱导排卵、人工授精和子宫内授精。2013年在 在美国，有近68，000名婴儿通过试管婴儿出生，占所有出生人数的1.7%， 在过去的十年里翻了一番。到目前为止，还没有一项基于人群的ART研究， 美国的IVF将ART治疗数据、出生结果、登记确认的出生缺陷和 学校表现。通过这项研究，我们试图填补这一知识空白。本研究旨在 评估死亡率、出生缺陷的风险以及对儿童小学成绩的影响 通过IVF和ART受孕的人，他们的兄弟姐妹，以及纽约、德克萨斯州、马萨诸塞州和北 卡罗莱纳。这项拟议的研究将基于2004年至2018年的出生人数，估计将包括163，000例试管婴儿 41，000名IVF兄弟姐妹和1，250，000名非IVF对照儿童。总体具体目标：比较 出生缺陷率和死亡率，以及对试管婴儿儿童学习成绩的影响， 非IVF ART和自发，包括兄弟姐妹。假设1：试管婴儿出生的孩子风险更高 出生缺陷的风险高于对照组;风险因治疗和父母特征而异。初级 目的：1）测试IVF和非IVF ART出生的出生缺陷风险是否高于IVF ART出生的风险。 自然受孕的分娩; 2）确定影响各组风险的父母因素; 3）在IVF中 组，以确定影响风险的治疗因素。假设2：试管婴儿出生的孩子 与他们的兄弟姐妹和非IVF对照儿童相比，死亡风险，主要是由于多个状态 （更大的可能性被认为是双胞胎，三胞胎，或四胞胎，但作为一个单胞胎出生;或有 出生时是双胞胎、三胞胎或四胞胎）以及相关的过度生长限制（小于胎龄） 和早产这一更大的围产期相关死亡风险被假设为不显著， 年龄，并因不孕治疗和父母因素而异（特别是年龄较大的产妇 分娩年龄和母亲教育程度较高）。假设3：试管婴儿出生的孩子 教育成绩较差的风险，更有可能需要特殊教育服务， 他们的兄弟姐妹和非IVF对照儿童，主要是由于他们的多元性状态（更大的可能性是 被视为双胞胎、三胞胎或四胞胎，但出生时为单胞胎;或出生时为双胞胎、三胞胎或四胞胎 四胞胎）和相关的过度生长限制（小于胎龄）和早产。这 更大的围产期相关的教育风险因不孕症治疗和父母因素而异（特别是 随着产妇分娩年龄的增加和产妇教育程度的提高而减少）。

项目成果

Assessment of Birth Defects and Cancer Risk in Children Conceived via In Vitro Fertilization in the US.

• DOI: 10.1001/jamanetworkopen.2020.22927
• 发表时间: 2020-10-01
• 期刊: JAMA network open
• 影响因子: 13.8
• 作者: Luke B;Brown MB;Nichols HB;Schymura MJ;Browne ML;Fisher SC;Forestieri NE;Rao C;Yazdy MM;Gershman ST;Ethen MK;Canfield MA;Williams M;Wantman E;Oehninger S;Doody KJ;Eisenberg ML;Baker VL;Lupo PJ
• 通讯作者: Lupo PJ

Defining critical factors in multi-country studies of assisted reproductive technologies (ART): data from the US and UK health systems.

定义辅助生殖技术 (ART) 多国研究中的关键因素：来自美国和英国卫生系统的数据。

• DOI: 10.1007/s10815-020-01951-y
• 发表时间: 2020
• 期刊: Journal of assisted reproduction and genetics
• 影响因子: 3.1
• 作者: Eisenberg,MichaelL;Luke,Barbara;Cameron,Katherine;Shaw,GaryM;Pacey,AllanA;Sutcliffe,AlastairG;Williams,Carrie;Gardiner,Julian;Anderson,RichardA;Baker,ValerieL
• 通讯作者: Baker,ValerieL

Sixth grade academic achievement among children conceived with IVF: a population-based study in Texas, USA.

通过体外受精受孕的儿童六年级的学业成绩：美国德克萨斯州的一项基于人群的研究。

• DOI: 10.1007/s10815-021-02170-9
• 发表时间: 2021
• 期刊: Journal of assisted reproduction and genetics
• 影响因子: 3.1
• 作者: Luke,Barbara;Brown,MortonB;Ethen,MaryK;Canfield,MarkA;Watkins,Stephanie;Wantman,Ethan;Doody,KevinJ
• 通讯作者: Doody,KevinJ

Pregnancy and birth outcomes in couples with infertility with and without assisted reproductive technology: with an emphasis on US population-based studies.

• DOI: 10.1016/j.ajog.2017.03.012
• 发表时间: 2017-09
• 期刊: AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
• 影响因子: 9.8
• 作者: Luke, Barbara

Third grade academic achievement among children conceived with the use of in vitro fertilization: a population-based study in Texas.

使用体外受精受孕的儿童三年级学业成绩：德克萨斯州的一项基于人口的研究。

• DOI: 10.1016/j.fertnstert.2020.01.015
• 发表时间: 2020
• 期刊: Fertility and sterility
• 影响因子: 6.7
• 作者: Luke,Barbara;Brown,MortonB;Ethen,MaryK;Canfield,MarkA;Watkins,Stephanie;Wantman,Ethan;Doody,KevinJ
• 通讯作者: Doody,KevinJ