CIENCIASMEDICASNEWS: Risk of congenital heart defects associated with assisted reproductive technologies: a population-based evaluation

miércoles, 11 de julio de 2012

Risk of congenital heart defects associated with assisted reproductive technologies: a population-based evaluation

+ Author Affiliations

¹Inserm, UMR S953, Recherche épidémiologique sur la santé périnatale et la santé des femmes et des enfants, UPMC, Université Paris-6, 82, avenue Denfert-Rochereau, 75014 Paris, France
²Service de chirurgie des cardiopathies congénitales, Hôpital Marie Lannelongue, 133, avenue de la Résistance, 92350 Le Plessis Robinson, France
³Centre de référence M3C-Necker, Université Paris Descartes, 140 rue de Sèvres, 75015 Paris, France
⁴Maternité Port Royal, Hôpital Cochin Saint-Vincent-de-Paul, Assistance Publique Hôpitaux de Paris, Université Paris-Descartes, 123, boulevard de Port-Royal, 75679 Paris Cedex 14, France

*Corresponding author. Tel: +33 1 42 34 55 70, Fax: +33 1 43 26 89 79, Email: karim.tararbit@inserm.fr

Received January 19, 2010.
Revision received September 21, 2010.
Accepted October 26, 2010.

Abstract

Aims To estimate the risk of congenital heart defects (CHD) associated with assisted reproductive technologies (ART).

Methods and results We used data from the Paris Registry of Congenital Malformations on 5493 cases of CHD and 3847 malformed controls for which no associations with ART were reported in the literature. Assisted reproductive technologies included inductors of ovulation only, in vitro fertilization, and intracytoplasmic sperm injection. Exposure to ART was higher for cases than controls (4.7 vs. 3.6%, P= 0.008) and was associated with a 40% increase in the maternal age, socioeconomic factors, and year of birth-adjusted odds of CHD without chromosomal abnormalities [adjusted odds ratio (OR) 1.4, 95% confidence interval (CI) 1.1–1.7]. Assisted reproductive technologies were specifically associated with significant increases in the odds of malformations of the outflow tracts and ventriculoarterial connections (adjusted OR 1.7, 95% CI 1.2–2.4) and of cardiac neural crest defects and double outlet right ventricle (adjusted OR 1.7, 95% CI 1.1–2.7). In general, we found specific associations between methods of ART and subcategories of CHD.

Conclusion Cases with CHD were more likely to have been conceived following ART when compared with malformed controls. This higher risk for CHD varied specifically according to the method of ART and the type of CHD and may be due to ART per se and/or the underlying infertility of couples.