Long-term cardiometabolic health in people born after assisted reproductive technology: a multi-cohort analysis.

MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK. Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK. NIHR Bristol Biomedical Research Centre, Bristol, UK. MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK. Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Singapore. Duke-NUS Medical School, Centre for Quantitative Medicine, Singapore, Singapore. Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia. University of Melbourne, Parkville, VIC, Australia. EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal. Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal. Department of Epidemiology, Lazio Regional Health Service, Rome, Italy. The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands. Department of Paediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands. Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway. Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China. School of Public Health, University College Cork, Cork, Ireland. The Irish Centre for Maternal and Child Health Research (INFANT), University College Cork, Cork, Ireland. Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece. Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece. Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland. Department of Mother and Child Health, Ospedale Versilia, Viareggio, AUSL Toscana Nord Ovest, Pisa, Italy. Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France. K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, Trondheim, Norway. HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, Levanger, Norway. Department of Endocrinology, Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia. Department of Paediatrics, Monash University, Clayton, VIC, Australia. Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore, Singapore. Academic Clinical Program in Obstetrics and Gynaecology, Duke-NUS Medical School, Singapore, Singapore. Department of Food, Nutrition and Dietetics, School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia. Department of Pediatrics and Child Health, University College Cork, Cork, Ireland. School of Medicine, University of Glasgow, Glasgow, UK. Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. Folkhälsan Research Center, Helsinki, Finland.

European heart journal. 2023;(16):1464-1473

Abstract

AIMS: To examine associations of assisted reproductive technology (ART) conception (vs. natural conception: NC) with offspring cardiometabolic health outcomes and whether these differ with age. METHODS AND RESULTS Differences in systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR), lipids, and hyperglycaemic/insulin resistance markers were examined using multiple linear regression models in 14 population-based birth cohorts in Europe, Australia, and Singapore, and results were combined using meta-analysis. Change in cardiometabolic outcomes from 2 to 26 years was examined using trajectory modelling of four cohorts with repeated measures. 35 938 (654 ART) offspring were included in the meta-analysis. Mean age ranged from 13 months to 27.4 years but was <10 years in 11/14 cohorts. Meta-analysis found no statistical difference (ART minus NC) in SBP (-0.53 mmHg; 95% CI:-1.59 to 0.53), DBP (-0.24 mmHg; -0.83 to 0.35), or HR (0.02 beat/min; -0.91 to 0.94). Total cholesterol (2.59%; 0.10-5.07), HDL cholesterol (4.16%; 2.52-5.81), LDL cholesterol (4.95%; 0.47-9.43) were statistically significantly higher in ART-conceived vs. NC offspring. No statistical difference was seen for triglycerides (TG), glucose, insulin, and glycated haemoglobin. Long-term follow-up of 17 244 (244 ART) births identified statistically significant associations between ART and lower predicted SBP/DBP in childhood, and subtle trajectories to higher SBP and TG in young adulthood; however, most differences were not statistically significant. CONCLUSION These findings of small and statistically non-significant differences in offspring cardiometabolic outcomes should reassure people receiving ART. Longer-term follow-up is warranted to investigate changes over adulthood in the risks of hypertension, dyslipidaemia, and preclinical and clinical cardiovascular disease.

Methodological quality

Publication Type : Meta-Analysis

Metadata