Article

AIM: To calculate the birth prevalence of cerebral palsy (CP) after assisted
reproductive technology (ART) and compare the clinical outcomes of children with
CP after ART or natural conception. METHOD: This cohort study used linked CP and
ART register data from live births in Western Australia (1994-2002). Birth
prevalence was calculated and data analysed using descriptive statistics and
logistic regression. It was adjusted for confounding variables and stratified by
plurality and gestational age. RESULTS: In total, 211 660 live births were
included; prevalence of CP was increased in children born after ART (7.2/1000
live births compared with naturally conceived births, 2.5/1000). Odds of CP were
doubled for singletons; when stratified by gestational age odds were only
increased in the under 32-week group. Prevalence of CP was increased in ART
(9.9/1000 live births) and naturally conceived twins (8.4/1000 live births).
Clinical outcomes were similar between ART and naturally conceived children.
INTERPRETATION: The birth prevalence of CP is increased two-fold after ART. After
stratification for gestational age and plurality, residual risk remains in
singletons born very preterm. Birth prevalence of CP will be tracked over time to
identify any impact of changes to clinical practice.
WHAT THIS PAPER ADDS: In
Western Australia, assisted reproductive technology (ART) increases birth
prevalence of cerebral palsy (CP), mediated mostly by preterm and multiple
births. Preterm birth alone does not account for the doubled odds of CP for ART
singletons born very preterm. Clinical outcomes are similar between ART and naturally conceived children with CP.
CI - (c) 2017 Mac Keith Press.

Langue : ANGLAIS