Cyanotic congenital heart disease following fertility treatments in the United States from 2011 to 2014

Heart. 2018 Jun;104(11):945-948. doi: 10.1136/heartjnl-2017-312015. Epub 2017 Nov 16.

Abstract

Objective: To examine the risk for cyanotic congenital heart diseases (CCHDs) among live births in the USA, resulting from various forms of infertility treatments.

Methods: This study is a cross-sectional analysis of live births in the USA from 2011 to 2014. Infertility treatments are categorised into two of the following groups on birth certificates: assisted reproductive technology (ART) fertility treatment (surgical egg removal; eg, in vitro fertilisation and gamete intrafallopian transfer) and non-ART fertility treatment (eg, medical treatment and intrauterine insemination). We compared the risk for CCHD in ART and non-ART fertility treatment groups with those infants whose mothers received no documented fertility treatment and were naturally conceived (NC).

Results: Among 14 242 267 live births from 2011 to 2014, a total of 101 494 live births were in the ART and 81 242 resulted from non-ART fertility treatments. CCHD prevalence in ART, non-ART and NC groups were 393/100 892 (0.39%), 210/80 884 (0.26%) and 10 749/14 020 749 (0.08%), respectively. As compared with naturally conceiving infants, risk for CCHD was significantly higher among infants born in ART (adjusted relative risk (aRR) 2.4, 95% CI 2.1 to 2.7) and non-ART fertility treatment groups (aRR 1.9, 95% CI 1.6 to 2.2). Absolute risk increase in CCHD due to ART and non-ART treatments were 0.03% and 0.02%, respectively. A similar pattern was observed when the analysis was restricted to twins, newborns with birth weights under 1500 g and gestational age of less than 32 weeks.

Conclusions: Our findings suggest an increased risk for CCHD in infants conceived after all types of infertility treatment.

Keywords: congenital heart disease; echocardiography; epidemiology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Female
  • Heart Defects, Congenital / epidemiology*
  • Humans
  • Infertility, Female / epidemiology
  • Infertility, Female / therapy*
  • Maternal Age
  • Middle Aged
  • Pregnancy
  • Reproductive Techniques, Assisted / adverse effects*
  • Risk Factors
  • Young Adult