Assisted reproductive technology and major structural birth defects in the United States.

CONCLUSIONS: These findings suggest that some birth defects occur more often among infants conceived with ART. Although the mechanism is not clear, couples considering ART should be informed of all potential risks and benefits.

Hum Reprod. 2009 Feb;24(2):360-6. Epub 2008 Nov 14.

Reefhuis J, Honein MA, Schieve LA, Correa A, Hobbs CA, Rasmussen SA; National Birth Defects Prevention Study.

National
Center on Birth Defects and Developmental Disabilities, Centers for
Disease Control and Prevention, 1600 Clifton Road N.E., MS E-86,
Atlanta, GA 30033, USA. nzr5 [at] cdc [dot] gov

BACKGROUND:
With >1% of US births occurring following use of assisted
reproductive technology (ART), it is critical to examine whether ART is
associated with birth defects.

METHODS: We analyzed data from the
National Birth Defects Prevention Study, a population-based,
multicenter, case-control study of birth defects. We included mothers
of fetuses or live-born infants with a major birth defect (case
infants) and mothers who had live-born infants who did not have a major
birth defect (control infants), delivered during the period October
1997-December 2003. We compared mothers who reported ART use (IVF or
ICSI) with those who had unassisted conceptions. Multiple logistic
regression was used to adjust for the following confounders: maternal
race/ethnicity, maternal age, smoking and parity; we stratified by
plurality.

RESULTS: ART was reported by 1.1% of all control mothers,
and by 4.5% of control mothers 35 years or older. Among singleton
births, ART was associated with septal heart defects (adjusted odds
ratio [aOR] = 2.1, 95% confidence intervals [CI] 1.1-4.0), cleft lip
with or without cleft palate (aOR = 2.4, 95% CI 1.2-5.1), esophageal
atresia (aOR = 4.5, 95% CI 1.9-10.5) and anorectal atresia (aOR = 3.7,
95% CI 1.5-9.1). Among multiple births, ART was not significantly
associated with any of the birth defects studied.