Assisted Reproductive Technology and Risk of Childhood Cancers.
JAMA Netw Open
; 5(8): e2230157, 2022 08 01.
Article
em En
| MEDLINE
| ID: mdl-36044210
ABSTRACT
Importance The number of children born through the use of assisted reproductive technology (ART) has been increasing. These children may have higher risks for epigenetic alteration and adverse perinatal outcomes, which may be associated with childhood cancers. Objective:
To determine the associations between different modes of conception and childhood cancers and potential mediation by preterm birth and low birth weight. Design, Setting, andParticipants:
This nationwide, population-based cohort study included registry data from 2â¯308â¯016 eligible parents-child triads in Taiwan from January 1, 2004, to December 31, 2017. A total of 1880 children with incident childhood cancer were identified. Data were analyzed between September 1, 2020, and June 30, 2022. Exposure Mode of conception, defined as (1) natural conception, (2) subfertility and non-ART (ie, infertility diagnosis but no ART-facilitated conception), or (3) ART (ie, infertility diagnosis and ART-facilitated conception). Main Outcomes andMeasures:
Diagnosis of childhood cancer according to the International Classification of Childhood Cancers, Third Edition.Results:
The mean (SD) paternal and maternal ages were 33.28 (5.07) and 30.83 (4.56) years, respectively. Of the 2â¯308â¯016 children, 52.06% were boys, 8.16% were born preterm, and 7.38% had low birth weight. During 14.9 million person-years of follow-up (median, 6 years [IQR, 3-10 years]), ART conception was associated with an increased risk of any type of childhood cancers compared with natural conception (hazard ratio, 1.58; 95% CI, 1.17-2.12) and subfertility with non-ART conception (hazard ratio, 1.42; 95% CI, 1.04-1.95). The increased cancer risk of children conceived with ART was mainly owing to leukemia and hepatic tumor. The increased cancer risk associated with ART conception was not mediated by preterm birth or low birth weight. Conclusions and Relevance In this cohort study, children conceived via ART had a higher risk of childhood cancers than those conceived naturally and those born to parents with an infertility diagnosis did not use ART. The increased risk could not be explained by preterm birth or low birth weight.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Nascimento Prematuro
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Infertilidade
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Neoplasias Hepáticas
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Child
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Female
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Humans
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Male
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Newborn
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Pregnancy
Idioma:
En
Revista:
JAMA Netw Open
Ano de publicação:
2022
Tipo de documento:
Article