title: Neurological sequelae in children born after in-vitro fertilisation: a population-based study.
abstract: BACKGROUND
  There is an absence of population-based long-term studies on the risk of neurological sequelae in children born after in-vitro fertilisation (IVF). Our aim was to compare the frequency of such problems between IVF-born children and controls.
  
  
  METHODS
  We did a population-based retrospective cohort study in which we compared development of neurological problems in 5680 children born after IVF, with 11360 matched controls. For 2060 twins born after IVF, a second set of controls (n=4120), all twins, were selected. We obtained data on neurological problems from the records of the Swedish habilitation centres.
  
  
  RESULTS
  Children born after IVF are more likely to need habilitation services than controls (odds ratio 1.7, 95% CI 1.3-2.2). For singletons, the risk was 1.4 (1.0-2.1). The most common neurological diagnosis was cerebral palsy, for which children born after IVF had an increased risk of 3.7(2.0-6.6), and IVF singletons of 2.8 (1.3-5.8). Suspected developmental delay was increased four-fold (1.9-8.3) in children born after IVF. Twins born after IVF did not differ from control twins with respect to risk of neurological sequelae. Low-birthweight and premature infants were more likely to need habilitation than fullterm babies. Maternal age did not affect risk.
  
  
  CONCLUSIONS
  Our study suggests that children born after IVF have an increased risk of developing neurological problems, especially cerebral palsy. These risks are largely due to the high frequency of twin pregnancies, low birthweight, and prematurity among babies born after IVF. To limit these risks, we recommend that only one embryo should be transferred during IVF.
authors.affiliation: Department of Women and Child Health, University Children's Hospital, 751 85, Uppsala, Sweden. bo.stromberg@kbh.uu.se
authors.forename: B
authors.initials: B
authors.lastname: Strömberg
authors.forename: G
authors.initials: G
authors.lastname: Dahlquist
authors.forename: A
authors.initials: A
authors.lastname: Ericson
authors.forename: O
authors.initials: O
authors.lastname: Finnström
authors.forename: M
authors.initials: M
authors.lastname: Köster
authors.forename: K
authors.initials: K
authors.lastname: Stjernqvist
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002547:Cerebral Palsy / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D008297:Male; D008423:Maternal Age; D011159:Population Surveillance; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013548:Sweden / Q000453:epidemiology; D014427:Twins