Perinatal outcome, health, growth, and medical care utilization of 5- to 8-year-old intracytoplasmic sperm injection singletons.
OBJECTIVE
To evaluate short- and long-term health in intracytoplasmic sperm injection (ICSI) singletons.


METHODS
Follow-up study.


METHODS
University medical center, assessments between March 2004 and May 2005.


METHODS
Singletons born between June 1996 and December 1999 after ICSI in the Leiden University Medical Center laboratory were compared with matched singletons born after IVF and natural conception.


METHODS
Mode of conception.


METHODS
An examiner blinded to the conception mode of the child assessed congenital malformations and growth. Information on pregnancy, perinatal period, birth defects, general health, and medical consumption was obtained through questionnaires.


RESULTS
Outcomes of children conceived by ICSI and IVF (n = 81/81, preterm infants excluded) were comparable or even more positive for ICSI. Perinatal outcomes were poorer after ICSI than natural conception: prematurity: P=.014; low birth weight: odds ratio = 7.4, 95% confidence interval (CI) [0.9; 62.5]; mean birth weight: Delta = 186 g, 95% CI [21; 351]. The ICSI mothers had more pregnancy complications (n = 33 vs. 18) and in-hospital deliveries (prevalence ratio 1.36, 95% CI 1.17; 1.48). No further differences were found between ICSI and natural conception children on congenital malformations, health, growth, and medical consumption (n = 87/85, preterm infants included).


CONCLUSIONS
No adverse health outcomes were identified in ICSI singletons up to age 5-8 years compared to IVF and natural conception singletons, besides poorer perinatal outcomes after ICSI versus natural conception.
Knoester
Marjolein
M
Department of Pediatrics, Neonatal Center, Leiden University Medical Center, Leiden, The Netherlands; Department of Gynecology, Division of Reproductive Medicine, Leiden University Medical Center, Leiden, The Netherlands.
Helmerhorst
Frans M
FM
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Gynecology, Division of Reproductive Medicine, Leiden University Medical Center, Leiden, The Netherlands.
Vandenbroucke
Jan P
JP
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
van der Westerlaken
Lucette A J
LAJ
Department of Gynecology, Division of Reproductive Medicine, Leiden University Medical Center, Leiden, The Netherlands.
Walther
Frans J
FJ
Department of Pediatrics, Neonatal Center, Leiden University Medical Center, Leiden, The Netherlands.
Veen
Sylvia
S
Department of Pediatrics, Neonatal Center, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: s.veen@lumc.nl.
D016022:Case-Control Studies; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D000013:Congenital Abnormalities / Q000209:etiology; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D009426:Netherlands; D011247:Pregnancy; D011256:Pregnancy Outcome; D020554:Sperm Injections, Intracytoplasmic / Q000009:adverse effects; D011795:Surveys and Questionnaires