title: Congenital anomalies identified at birth among infants born following assisted reproductive technology in Colorado.
abstract: BACKGROUND
  Assisted reproductive technology (ART) has assisted many infertile couples in conceiving. Despite increasing use in the United States, the association between ART and congenital anomalies remains a highly contested subject. We conducted a study to examine the risk of congenital anomalies among infants conceived using ART.
  
  
  METHODS
  A retrospective cohort study of 344,567 infants born in Colorado from 2007 to 2011 was conducted using data obtained from the Colorado Birth Certificate Database. The incidence of congenital anomalies identified at birth following conception with ART was assessed and compared with all naturally conceived infants born during the same time period. The odds ratio was calculated using multiple logistic regression after adjusting for multiple confounders.
  
  
  RESULTS
  Of 2071 infants, 23 (1.11%) conceived using ART had a congenital anomaly identified at birth compared with 3826 (1.12%) of 342,496 infants conceived naturally. The adjusted odds ratio of a congenital anomaly among infants born following conception with ART was 1.01 (95% confidence interval, 0.67-1.52). The proportion of infants born following usage of ART in Colorado has not changed significantly (p = 0.20) from 2007 to 2011 with an overall proportion of 0.60% (range 0.52-0.64%), while the incidence of congenital anomalies has decreased significantly (p = 0.002) during the study years with an average of 1.12% (range, 0.92-1.25%).
  
  
  CONCLUSIONS
  This study suggests that conception by means of ART is not associated with an increased risk of congenital abnormalities identified by birth certificate data in Colorado when compared with births following natural conception.
authors.affiliation: Colorado School of Public Health, University of Colorado, Denver, Colorado.
authors.forename: X J Ethan
authors.initials: XJ
authors.lastname: Moses
authors.forename: Tirsa
authors.initials: T
authors.lastname: Torres
authors.forename: Anna
authors.initials: A
authors.lastname: Rasmussen
authors.forename: Christopher
authors.initials: C
authors.lastname: George
mesh_terms: D000293:Adolescent; D000328:Adult; D001719:Birth Certificates; D002648:Child; D003120:Colorado / Q000453:epidemiology; D000013:Congenital Abnormalities / Q000175:diagnosis / Q000453:epidemiology*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data*; D012189:Retrospective Studies
keywords: Colorado; assisted reproductive technology; birth defects; congenital anomalies; in vitro fertilization; incidence; malformations; prevalence