Parental infertility and cerebral palsy in children.
BACKGROUND
Children born after in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) have been reported to have a higher risk of cerebral palsy (CP), perhaps due to the higher frequency of preterm birth, multiple births or vanishing embryo in the pregnancies. However, it has been suggested that the underlying infertility may be part of the pathway. In this study, we examined whether untreated subfecundity (measured by time to pregnancy) or infertility treatment was associated with an increased risk of CP in the offspring.


METHODS
Using the Danish National Birth Cohort (1997-2003), we compared children born after 0-2 months of waiting time to pregnancy (n = 35 848) with those born after a time to pregnancy of 3-5 months (n = 15 361), 6-12 months (n = 11 528) and >12 months (n = 7387), as well as those born after IVF/ICSI (n = 3617), ovulation induction with or without intrauterine insemination (n = 3000), and unplanned pregnancies (n = 13 462). CP cases were identified through the Danish CP Register.


RESULTS
In total, 165 (0.18%) children were diagnosed with CP in the entire cohort. We found no significant association between time to pregnancy and the risk of CP in children conceived spontaneously. Children born after IVF/ICSI had an increased risk of CP, even after adjustment for preterm birth and multiplicity (hazard ratio 2.30, 95% confidence interval 1.12-4.73).


CONCLUSIONS
Subfecundity per se did not appear to be associated with the risk of CP in children, whereas being born after IVF/ICSI conferred an increased risk.
The Danish Epidemiology Science Centre, Department of Epidemiology, School of Public Health, University of Aarhus, Aarhus C, Denmark. zjl@soci.au.dk
Jin Liang
JL
Zhu
Dorte
D
Hvidtjørn
Olga
O
Basso
Carsten
C
Obel
Poul
P
Thorsen
Peter
P
Uldall
Jørn
J
Olsen
D002547:Cerebral Palsy / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects; D006801:Humans; D007246:Infertility / Q000209:etiology; D011247:Pregnancy; D012042:Registries; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects; D020554:Sperm Injections, Intracytoplasmic / Q000009:adverse effects