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Are Assisted Reproductive Technology pregnancies more likely to be exposed to teratogenic medication? A whole-population study.

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dc.contributor.authorKemp Casey, A.
dc.contributor.authorHart, R.
dc.contributor.authorMilne, E.
dc.contributor.authorBower, C.
dc.contributor.authorWalls, M.L.
dc.contributor.authorYovich, J.L.
dc.contributor.authorBurton, P.
dc.contributor.authorLiu, Y.
dc.contributor.authorBarblett, H.
dc.contributor.authorHansen, M.
dc.date.issued2024
dc.description.abstractBackground: Assisted reproductive technology (ART) pregnancies are at greater risk of birth defects than non-ART pregnancies. Teratogenic medication exposure is a potential cause of birth defects that has not been compared between ART and non-ART pregnancies. Aims: To determine whether the prevalence of exposure to teratogenic medicines during pregnancy varies by conception method (ART and three non-ART groups: ovulation induction (OI), subfertile untreated, and fertile naturally conceiving). Materials and Methods: We linked state and commonwealth datasets for all live and stillbirths (≥20 weeks) in Western Australia with a conception date ≥1 July 2012 and date of birth ≤31 December 2014. We calculated the prevalence of exposure to teratogenic medicines (Therapeutic Goods Association Category D/X) across conception groups for the: (i) first trimester, and (ii) second and third trimesters. Results: We identified 2041 ART, 590 OI, 2063 subfertile and 52 987 fertile pregnancies (57 681). The overall prevalence of exposure to Category D/X medicines was 0.8% in the first trimester, and 0.7% in the second and third trimesters. Category X medicines exposure was <0.5% for all conception groups and trimesters. The first trimesters of ART and OI pregnancies were more often exposed to Category D medicines than subfertile and fertile pregnancies, (ART = 4.9%, OI = 2.0% vs subfertile = 1.3%, fertile = 0.6%) as were later trimesters (ART = 3.4%, OI = 1.4% vs subfertile = 0.9%, fertile = 0.6%). Conclusions: The overall prevalence of exposure to teratogenic medicines is low; however, exposure was greatest in pregnancies arising from ART and may be a modest contributing factor to the higher rate of birth defects observed among ART babies.
dc.identifier.citationAustralian and New Zealand Journal of Obstetrics and Gynaecology, 2024; 65(3):390-397
dc.identifier.doi10.1111/ajo.13911
dc.identifier.issn0004-8666
dc.identifier.issn1479-828X
dc.identifier.urihttps://hdl.handle.net/11541.2/41070
dc.language.isoen
dc.publisherJohn Wiley & Sons
dc.relation.fundingNHMRC 1086530
dc.rightsCopyright 2024 Royal Australian and New Zealand College of Obstetricians and Gynaecologists Access Condition Notes: Accepted manuscript available after 1 January 2026
dc.source.urihttps://doi.org/10.1111/ajo.13911
dc.subjectdrug utilisation
dc.subjectpharmacoepidemiology
dc.subjectreproductive techniques (assisted)
dc.subjectteratogens
dc.titleAre Assisted Reproductive Technology pregnancies more likely to be exposed to teratogenic medication? A whole-population study.
dc.typeJournal article
pubs.publication-statusPublished
ror.fileinfo12295994570001831 13295994560001831 Open Access Postprint
ror.mmsid9916917427601831

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