Assessment of Birth Defects and Cancer Risk in Children Conceived via In Vitro Fertilization in the US.
JAMA Netw Open
; 3(10): e2022927, 2020 10 01.
Article
em En
| MEDLINE
| ID: mdl-33119107
ABSTRACT
Importance Children with birth defects have a greater risk of developing cancer, but this association has not yet been evaluated in children conceived with in vitro fertilization (IVF). Objective:
To assess whether the association between birth defects and cancer is greater in children conceived via IVF compared with children conceived naturally. Design, Setting, andParticipants:
This cohort study of live births, birth defects, and cancer from Massachusetts, New York, North Carolina, and Texas included 1â¯000â¯639 children born to fertile women and 52â¯776 children conceived via IVF (using autologous oocytes and fresh embryos) during 2004-2016 in Massachusetts and North Carolina, 2004-2015 in New York, and 2004-2013 in Texas. Children were followed up for an average of 5.7 years (6â¯008â¯985 total person-years of exposure). Data analysis was conducted from April 1 to August 31, 2020. Exposures Conception by IVF for state residents who gave birth to liveborn singletons during the study period. Birth defect diagnoses recorded by statewide registries. Main Outcomes andMeasures:
Cancer diagnosis as recorded by state cancer registries. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% CIs for birth defect-cancer associations separately in fertile and IVF groups.Results:
A total of 1â¯000â¯639 children (51.3% boys; 69.7% White; and 38.3% born between 2009-2012) were in the fertile group and 52â¯776 were in the IVF group (51.3% boys; 81.3% White; and 39.6% born between 2009-2012). Compared with children without birth defects, cancer risks were higher among children with a major birth defect in the fertile group (hazard ratio [HR], 3.15; 95% CI, 2.40-4.14) and IVF group (HR, 6.90; 95% CI, 3.73-12.74). The HR of cancer among children with a major nonchromosomal defect was 2.07 (95% CI, 1.47-2.91) among children in the fertile group and 4.04 (95% CI, 1.86-8.77) among children in the IVF group. The HR of cancer among children with a chromosomal defect was 15.45 (95% CI, 10.00-23.86) in the fertile group and 38.91 (95% CI, 15.56-97.33) in the IVF group. Conclusions and Relevance This study found that among children with birth defects, those conceived via IVF were at greater risk of developing cancer compared with children conceived naturally.
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Base de dados:
MEDLINE
Assunto principal:
Anormalidades Congênitas
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Fertilização in vitro
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Medição de Risco
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Neoplasias
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article