Risk of congenital heart defects associated with assisted reproductive technologies: a population-based evaluation.
OBJECTIVE
To estimate the risk of congenital heart defects (CHD) associated with assisted reproductive technologies (ART).


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.


CONCLUSIONS
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.
Inserm, UMR S953, Recherche épidémiologique sur la santé périnatale et la santé des femmes et des enfants, UPMC, Université Paris, Paris, France. karim.tararbit@inserm.fr
Karim
K
Tararbit
Lucile
L
Houyel
Damien
D
Bonnet
Catherine
C
De Vigan
Nathalie
N
Lelong
François
F
Goffinet
Babak
B
Khoshnood
D016022:Case-Control Studies; D002648:Child; D005260:Female; D005333:Fetus / Q000002:abnormalities; D006330:Heart Defects, Congenital / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology / Q000628:therapy; D008423:Maternal Age; D010297:Paris / Q000453:epidemiology; D012042:Registries; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects*; D012307:Risk Factors; D012959:Socioeconomic Factors