Assisted Reproductive Technology and Risk of Congenital Heart Defects in the Offspring: A Systematic Review and Meta-Analysis.
Riccardo Rinaldi, Kamil Bujak, Claudio Laudani et al.
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In 30 seconds
This systematic review and meta-analysis assessed congenital heart defect (CHD) risk in offspring conceived through assisted reproductive technology (ART) compared with spontaneous conception. Thirteen studies involving 45 916 925 subjects, including 4986 conceived via ART, contributed to the quantitative synthesis. ART was associated with a higher risk of major CHDs (risk ratio, 2.35 [95% CI, 1.68-3.28]), although results varied significantly across studies. Increased risks were also reported for tetralogy of Fallot, ventricular septal defect, and atrial septal defect; no difference was found for the other CHDs assessed.
Key findings
- ART was associated with higher major CHD risk than spontaneous conception: risk ratio, 2.35 [95% CI, 1.68-3.28].
- The analysis included 13 studies and 45 916 925 subjects, of whom 4986 were conceived via ART.
- ART-conceived pregnancies were associated with increased risks of tetralogy of Fallot, ventricular septal defect, and atrial septal defect.
- No difference was found for the other CHD subtypes assessed; significant heterogeneity was present across studies.
Why it matters
The findings indicate a potential association between ART conception and major CHDs, with signals for several specific defects. This is relevant to understanding pregnancy and offspring outcomes in the context of ART. Because the evidence is based on pooled studies with significant heterogeneity, the association should be interpreted cautiously and does not establish that ART causes these defects.
What to keep in mind
Significant heterogeneity across studies limits the consistency of the pooled estimate; the meta-analysis reports associations and does not establish causation.