Objective: To investigate the incidence of fetal heart defects in assisted reproductive technology (ART)-induced pregnancies compared to natural pregnancies as well as to detect their fetal and maternal risk factors associated with ART.
Methods: In this retrospective cohort study, we collected data from the medical records belonging to 2877 pregnant women's fetuses, who underwent fetal echocardiography for various reasons, including ART, over the last 3 years.
Results: There were no major cardiac anomaly in the ART-induced pregnancies, while it was seen in 1.32% of natural pregnancies; so, ART did not increase the risk of major cardiac anomalies. However, the incidence of fetal mild cardiac anomalies among fetuses derived from ART-induced pregnancies (51.43%) was significantly higher than that of natural pregnancies (44.43%, p=0.03). None of the ART-induced pregnancies had a history of a child with cardiac disease (vs. 7.56% in natural pregnancies). Also, the increased nuchal thickness (NT) and extra-cardiac anomalies were significantly more prevalent among natural pregnancies, indicating a significant negative correlation between ART and these two risk factors [χ2=10.24, r: -0.06, 95% CI(-0.0974 to -0.0221) and χ2=47.25, r: -0.129, 95% CI(-0.1656 to -0.0913), p<0.01, respectively]. The adjusted odds ratio of developing fetal mild cardiac anomalies were 1.37 times higher greater for ART-induced pregnancies compared to natural pregnancies [95% CI(1.072-1.769), p=0.01].
Conclusions: Although the likelihood of developing fetal mild cardiac anomalies was 1.37 times higher for ART-induced pregnancy compared to natural pregnancy, ART did not increase the risk of major cardiac anomalies Although the likelihood of developing fetal mild cardiac anomalies was 1.37 times higher for ART-induced pregnancy compared to natural pregnancy, ART did not increase the risk of major cardiac anomalies.
Keywords: Assisted reproductive technology; fetus; heart defect.