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The growth of assisted reproductive treatment-conceived children from birth to 5 years: A national cohort study

The growth of assisted reproductive treatment-conceived children from birth to 5 years: A national cohort study
The growth of assisted reproductive treatment-conceived children from birth to 5 years: A national cohort study

Background: Birth weight and early child growth are important predictors of long-term cardiometabolic disease risk, in line with the Developmental Origins of Health and Disease hypothesis. As human assisted reproductive technologies (ARTs) occur during the sensitive periconceptional window of development, it has recently become a matter of urgency to investigate risk in ART-conceived children. Methods: We have conducted the first large-scale, national cohort study of early growth in ART children from birth to school age, linking the register of ART, held by the UK's Human Fertilisation and Embryology Authority, to Scottish maternity and child health databases. Results: In this study of 5200 ART and 20,800 naturally conceived (NC) control children, linear regression analysis revealed the birthweight of babies born from fresh embryo transfer cycles is 93.7 g [95% CI (76.6, 110.6)g] less than NC controls, whereas babies born from frozen embryo transfer (FET) cycles are 57.5 g [95% CI (30.7, 86.5)g] heavier. Fresh ART babies grew faster from birth (by 7.2 g/week) but remained lighter (by 171 g), at 6-8 weeks, than NC babies and 133 g smaller than FET babies; FET and NC babies were similar. Length and occipital-frontal circumference followed the same pattern. By school entry (4-7 years), weight, length and BMI in boys and girls conceived by fresh ART and FET were similar to those in NC children. Conclusions: ART babies born from fresh embryo transfer grow more slowly in utero and in the first few weeks of life, but then show postnatal catch up growth by school age, compared to NC and FET babies. As low birth weight and postnatal catch-up are independent risk factors for cardiometabolic disease over the life-course, we suggest that further studies in this area are now warranted.

Assisted reproductive technology, Birth weight, Child growth, Data linkage
Hann, Mark
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Roberts, Stephen A.
bceeee0c-db81-4d14-9976-fa22466991a0
D'Souza, Stephen W.
24513ae3-0341-4f06-a7dc-bc33f00e18e8
Clayton, Peter
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Macklon, Nick
7db1f4fc-a9f6-431f-a1f2-297bb8c9fb7e
Brison, Daniel R.
95076105-60d2-4fbe-9c88-e0f1cbc75787
Hann, Mark
0438c864-9e6d-4808-974f-4d8755cfe2bb
Roberts, Stephen A.
bceeee0c-db81-4d14-9976-fa22466991a0
D'Souza, Stephen W.
24513ae3-0341-4f06-a7dc-bc33f00e18e8
Clayton, Peter
9a9e0492-48b6-4de2-b141-bd6461b6e536
Macklon, Nick
7db1f4fc-a9f6-431f-a1f2-297bb8c9fb7e
Brison, Daniel R.
95076105-60d2-4fbe-9c88-e0f1cbc75787

Hann, Mark, Roberts, Stephen A., D'Souza, Stephen W., Clayton, Peter, Macklon, Nick and Brison, Daniel R. (2018) The growth of assisted reproductive treatment-conceived children from birth to 5 years: A national cohort study. BMC Medicine, 16 (1), [224]. (doi:10.1186/s12916-018-1203-7).

Record type: Article

Abstract

Background: Birth weight and early child growth are important predictors of long-term cardiometabolic disease risk, in line with the Developmental Origins of Health and Disease hypothesis. As human assisted reproductive technologies (ARTs) occur during the sensitive periconceptional window of development, it has recently become a matter of urgency to investigate risk in ART-conceived children. Methods: We have conducted the first large-scale, national cohort study of early growth in ART children from birth to school age, linking the register of ART, held by the UK's Human Fertilisation and Embryology Authority, to Scottish maternity and child health databases. Results: In this study of 5200 ART and 20,800 naturally conceived (NC) control children, linear regression analysis revealed the birthweight of babies born from fresh embryo transfer cycles is 93.7 g [95% CI (76.6, 110.6)g] less than NC controls, whereas babies born from frozen embryo transfer (FET) cycles are 57.5 g [95% CI (30.7, 86.5)g] heavier. Fresh ART babies grew faster from birth (by 7.2 g/week) but remained lighter (by 171 g), at 6-8 weeks, than NC babies and 133 g smaller than FET babies; FET and NC babies were similar. Length and occipital-frontal circumference followed the same pattern. By school entry (4-7 years), weight, length and BMI in boys and girls conceived by fresh ART and FET were similar to those in NC children. Conclusions: ART babies born from fresh embryo transfer grow more slowly in utero and in the first few weeks of life, but then show postnatal catch up growth by school age, compared to NC and FET babies. As low birth weight and postnatal catch-up are independent risk factors for cardiometabolic disease over the life-course, we suggest that further studies in this area are now warranted.

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Accepted/In Press date: 30 October 2018
e-pub ahead of print date: 28 November 2018
Keywords: Assisted reproductive technology, Birth weight, Child growth, Data linkage

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Local EPrints ID: 426925
URI: http://eprints.soton.ac.uk/id/eprint/426925
PURE UUID: 96f8a84e-3b7f-4197-bc9f-1db27c5029f3

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Date deposited: 18 Dec 2018 17:30
Last modified: 25 Nov 2021 16:58

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Contributors

Author: Mark Hann
Author: Stephen A. Roberts
Author: Stephen W. D'Souza
Author: Peter Clayton
Author: Nick Macklon
Author: Daniel R. Brison

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