Is the probability of prenatal diagnosis or termination of pregnancy different for fetuses with congenital anomalies conceived following assisted reproductive techniques? A population-based evaluation of fetuses with congenital heart defects.
OBJECTIVE
To compare the probability of prenatal diagnosis (PND) and termination of pregnancy for fetal anomaly (TOPFA) between fetuses conceived by assisted reproductive techniques (ART) and spontaneously-conceived fetuses with congenital heart defects (CHD).


METHODS
Population-based observational study.


METHODS
Paris and surrounding suburbs.


METHODS
Fetuses with CHD in the Paris registry of congenital malformations and cohort of children with CHD (Epicard).


METHODS
Comparison of ART-conceived and spontaneously conceived fetuses taking into account potential confounders (maternal characteristics, multiplicity and year of birth or TOPFA).


METHODS
Probability and gestational age at PND and TOPFA for ART-conceived versus spontaneously conceived fetuses.


RESULTS
The probability of PND (28.1% versus 34.6%, P = 0.077) and TOPFA (36.2% versus 39.2%, P = 0.677) were not statistically different between ART-conceived (n = 171) and spontaneously conceived (n = 4620) fetuses. Estimates were similar after adjustment for potential confounders. Gestational age at PND tended to be earlier for ART fetuses (23.1 versus 24.8 weeks, P = 0.05) but no statistical difference was found after adjustment for confounders. Gestational age at TOPFA was comparable between ART-conceived and spontaneously conceived fetuses.


CONCLUSIONS
In our population, ART conception was not significantly associated with the probability of PND or TOPFA for CHD. One implication of our results is that live births may be adequate for assessing the overall risk of CHD related to ART. However, total prevalence, in particular of severe CHD, would not be adequately assessed if TOPFA are not included.
Inserm UMR 1153, Equipe de recherche en Epidémiologie Obstétricale, Périnatale et Pédiatrique (EPOPé), Centre de Recherche Epidémiologie et Statistique Sorbonne Paris Cité DHU Risques et grossesse, Université Paris Descartes, Paris, France.
K
K
Tararbit
Inserm UMR 1153, Equipe de recherche en Epidémiologie Obstétricale, Périnatale et Pédiatrique (EPOPé), Centre de Recherche Epidémiologie et Statistique Sorbonne Paris Cité DHU Risques et grossesse, Université Paris Descartes, Paris, France.
N
N
Lelong
Centre Pluridisciplinaire de Diagnostic Prénatal de l'Est Parisien, Pôle de périnatalité, Hôpital Trousseau, Paris, France.
J-M
JM
Jouannic
Inserm UMR 1153, Equipe de recherche en Epidémiologie Obstétricale, Périnatale et Pédiatrique (EPOPé), Centre de Recherche Epidémiologie et Statistique Sorbonne Paris Cité DHU Risques et grossesse, Université Paris Descartes, Paris, France.|Maternité Port Royal, Hôpital Cochin, Hôpitaux Paris Centre, Assistance Publique Hôpitaux de Paris, Paris, France.
F
F
Goffinet
Inserm UMR 1153, Equipe de recherche en Epidémiologie Obstétricale, Périnatale et Pédiatrique (EPOPé), Centre de Recherche Epidémiologie et Statistique Sorbonne Paris Cité DHU Risques et grossesse, Université Paris Descartes, Paris, France.
B
B
Khoshnood
D000028:Abortion, Induced / Q000706:statistics & numerical data*; D000328:Adult; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis / Q000453:epidemiology*; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000706:statistics & numerical data*; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects / Q000706:statistics & numerical data*; D012307:Risk Factors; D055815:Young Adult
Assisted; congenital; epidemiology/population-based; heart defects; prenatal diagnosis; reproductive techniques; termination of pregnancy for fetal anomaly