Summary: A study of 1.3 million children found that children born to parents with birth defects are slightly more likely to develop autism spectrum disorder (ASD). According to the study, there is an increased risk of ASD in parents who have undergone previous infertility treatment.
The study highlights the role of obstetric factors such as multiple pregnancy and preterm birth in mediating this association. More research is needed to investigate the mechanisms behind this link.
Key facts:
- Children born to parents with infertility are slightly more likely to develop autism spectrum disorder (ASD).
- This increased risk is independent of the use of fertility treatments.
- Obstetric factors such as twins or preterm birth indicate a significant association between parental infertility and ASD.
Source: Queen’s University
One in 50 Canadian children has autism spectrum disorder (ASD), a neurodevelopmental condition that can affect sensory processing, communication, and emotional and behavioral regulation. However, the causes of this lifelong disorder are unclear and are likely to be a combination of genetic and environmental factors.
A new study was published today JAMA Network Open It reports on a cohort study of more than 1.3 million babies born in Ontario between 2006 and 2018. The findings show that children born to individuals diagnosed with birth defects have a slightly higher risk of ASD.
With infertility testing on the rise, it is estimated that one in six couples will go through this ordeal – publicly funded fertility programs have increased fertility treatment in Canada. Along with this development, there is a need to answer questions about the health outcomes for mothers and children who receive prenatal care.
The newly published study, led by Maria Velez (obstetrics and gynecology), reviewed administrative health data related to pregnancy and infant characteristics associated with infertility, its treatments and ASD.
Children were divided by conception: unassisted (86.5%), fertility treatment or infertility (10.3%), infertility (10.3%), ovulation induction or in vitro fertilization (1.5%), and in vitro fertilization or intracytoplasmic sperm injection (1.7%). .
From 18 months, children from 5 to 11 years were followed, and 22,409 children were diagnosed with ASD, or 1.6 percent of the total. Because not all children were followed for the same amount of time, ASD incidence rates were calculated in body-years—a measure that takes into account the number of people in the study and the amount of time each person spent in the study.
For example, a study that follows 1,000 people for one year contains 1,000 person-years of data.
In this study, the incidence rate of ASD was 1.9 per 1,000 person-years among children in the first group, and was higher among children in the postnatal (2.5) and postnatal treatment (2.7) groups.
The results indicate that patients with previous infertility problems are less likely to develop ASD in their children, regardless of whether they received fertility treatment or not.
“Furthermore, our results show that certain obstetric factors, such as having twins or triplets or giving birth prematurely, mediate the association between parental infertility and ASD,” Dr. Velez said.
According to the authors, the findings support ongoing efforts to reduce the risk of multiple pregnancies and preterm births following fertility treatments, as well as the importance of developing advance care plans for pregnant patients who receive such treatments, aimed at reducing adverse pregnancies. Results in this population.
Further studies are needed to understand some of the mechanisms by which parental infertility screening, independent of fertility treatment, may lead to a slightly higher risk of ASD in the child.
“For example, we need more detailed information about the diagnosis of infertility, the causes of paternity, and whether the oocyte (egg) or sperm is from a parent or donor, among other things,” explains Dr. Velez.
So autism research news
Author: Katarina Chagas
Source: Queen’s University
Contact: Katarina Chagas – Queen’s University
Image: Image credited to Neuroscience News.
Preliminary study: Open Access.
“Infertility and the risk of autism spectrum disorder in children“By Maria Velez et al. JAMA Network Open
Draft
Infertility and the risk of autism spectrum disorder in children
Importance
Previous studies on the risk of childhood autism spectrum disorder (ASD) following fertility treatment have not found infertility itself or maternal and neonatal conditions to mediate effects.
Purpose
To assess the mediating effects of infertility and the treatments on the risk of ASD and selected adverse pregnancy outcomes.
Design, composition and participants
This was a population-based cohort study in Ontario, Canada. Participants were all singleton and multiple fetuses born between 2006 and 2018 at 24 or more weeks’ gestation. The data was analyzed from October 2022 to October 2023.
Exposure
The exposure was method of conception, ie, (1) missed conception, (2) infertility without fertility treatment (ie, infertility), (3) ovulation induction (OI) or intrauterine insemination (IUI), or (4) In vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).
Main results and measurements
The outcome of the study is the diagnosis of ASD at the age of 18 months or older. Cox regression models generated hazard ratios (HR) adjusted for maternal and child characteristics. Mediation analysis for (1) preeclampsia, (2) cesarean delivery, (3) multiple gestation, (4) preterm birth at less than 37 weeks, and (5) severe neonatal morbidity.
Results
A total of 1 370 152 children (703 407 boys [51.3%]) included: 1 185 024 (86.5%) with unassisted conception, 141 180 (10.3%) with parentage, 20 429 (1.5%) following OI or III, and 23 519 (1.7%) following IVF or ICSI. Individuals with obstetrics or gynecology were older and lived in higher-income areas; The mean (SD) age of each group was as follows: 30.1 (5.2) in the unassisted conception group, 33.3 (4.7) in the induction group, 33.1 (4.4) in the OI or IUI group, and 35.8 (4.9) years. ) years in the IVF or ICSI group.
The incidence rate of ASD was 1.93 per 1000 children in the unassisted birth cohort. For the latter, the adjusted HR for ASD was 1.20 (95% CI, 1.15–1.25) in the subfertility group, 1.21 (95% CI, 1.09–1.34) following OI or IUI, and 1.16 (95% CI, 1.04–1.25). 1.28) after IVF or ICSI. Maternal and neonatal factors moderate the above-mentioned association between conception and ASD risk. For example, following IVF or ICSI, the median rate of cesarean delivery is 29%, multiple pregnancy 78%, preterm birth 50%, and severe neonatal morbidity 25%.
Conclusions and relevance
In this cohort study, a slightly higher risk of ASD was observed in children born to infertile individuals, which appears to be mediated in part by some maternal and neonatal factors. Strategies to optimize children’s neurodevelopment should be explored in individuals with these other causes of infertility, even among those who do not receive fertility treatment.