Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/72417
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Type: Journal article
Title: Reproductive technologies and the risk of birth defects
Author: Davies, M.
Moore, V.
Willson, K.
van Essen, P.
Priest, K.
Scott, H.
Haan, E.
Chan, A.
Citation: New England Journal of Medicine, 2012; 366(19):1803-1813
Publisher: Massachusetts Medical Society
Issue Date: 2012
ISSN: 0028-4793
1533-4406
Statement of
Responsibility: 
Michael J. Davies, Vivienne M. Moore, Kristyn J. Willson, Phillipa Van Essen, Kevin Priest, Heather Scott, Eric A. Haan and Annabelle Chan
Abstract: BACKGROUND: The extent to which birth defects after infertility treatment may be explained by underlying parental factors is uncertain. METHODS: We linked a census of treatment with assisted reproductive technology in South Australia to a registry of births and terminations with a gestation period of at least 20 weeks or a birth weight of at least 400 g and registries of birth defects (including cerebral palsy and terminations for defects at any gestational period). We compared risks of birth defects (diagnosed before a child’s fifth birthday) among pregnancies in women who received treatment with assisted reproductive technology, spontaneous pregnancies (i.e., without assisted conception) in women who had a previous birth with assisted conception, pregnancies in women with a record of infertility but no treatment with assisted reproductive technology, and pregnancies in women with no record of infertility. RESULTS: Of the 308,974 births, 6163 resulted from assisted conception. The unadjusted odds ratio for any birth defect in pregnancies involving assisted conception (513 defects, 8.3%) as compared with pregnancies not involving assisted conception (17,546 defects, 5.8%) was 1.47 (95% confidence interval [CI], 1.33 to 1.62); the multivariate-adjusted odds ratio was 1.28 (95% CI, 1.16 to 1.41). The corresponding odds ratios with in vitro fertilization (IVF) (165 birth defects, 7.2%) were 1.26 (95% CI, 1.07 to 1.48) and 1.07(95% CI, 0.90 to 1.26), and the odds ratios with intracytoplasmic sperm injection (ICSI) (139 defects, 9.9%) were 1.77 (95% CI, 1.47 to 2.12) and 1.57 (95% CI, 1.30 to 1.90). A history of infertility, either with or without assisted conception, was also significantly associated with birth defects. CONCLUSIONS: The increased risk of birth defects associated with IVF was no longer significant after adjustment for parental factors. The risk of birth defects associated with ICSI remained increased after multivariate adjustment, although the possibility of residual confounding cannot be excluded. (Funded by the National Health and Medical Research Council and the Australian Research Council.)
Keywords: Congenital Abnormalities
Rights: Copyright © 2012 Massachusetts Medical Society. All rights reserved.
DOI: 10.1056/NEJMoa1008095
Grant ID: http://purl.org/au-research/grants/nhmrc/349475
http://purl.org/au-research/grants/nhmrc/349548
http://purl.org/au-research/grants/nhmrc/453556
http://purl.org/au-research/grants/nhmrc/465455
http://purl.org/au-research/grants/arc/FT100101018
Published version: http://www.scopus.com/inward/record.url?eid=2-s2.0-84860702705&partnerID=40&md5=4bb9ec7718e9dea3f136b848c70af052
Appears in Collections:Aurora harvest
Obstetrics and Gynaecology publications

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