Neurodevelopmental Outcomes of VLBW Preterm Infants Conceived by Assisted Reproductive Technology

Vollständiger Abstract

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OBJECTIVE We aimed to compare perinatal and neurodevelopmental outcomes between very low birth weight (VLBW) preterm infants conceived by assisted reproductive technology (ART) and infants conceived spontaneously. METHODS This retrospective multicenter cohort study used data from the Taiwan Premature Infant Follow-up Network database on infants born between 1998 and 2017. Primary outcomes were survival to hospital discharge and neurodevelopmental impairment (NDI) at 2 years’ corrected age. Adjusted risk ratios (aRRs) for NDI were estimated using modified Poisson regression with broader and confounder-only adjustment strategies, with prespecified sensitivity analyses including multiple gestation. RESULTS The study population comprised 19 901 preterm VLBW infants, of whom 3762 (18.9%) were conceived by ART. Compared with the spontaneous conception group, the ART group had more multiple gestations and older, more educated parents (all P < .001). Survival to hospital discharge was higher among ART-conceived infants than among spontaneously conceived infants (86.3% vs 84.8%; P = .03), whereas NDI at 2 years’ corrected age was lower in crude comparisons (21.6% vs 23.5%; P = .05). In modified Poisson regression analyses, ART exposure was not significantly associated with NDI in the broader adjusted model (aRR, 0.96; 95% CI, 0.89–1.03) or the confounder-only model (aRR, 0.93; 95% CI, 0.85–1.02). In a broader sensitivity model additionally including multiple gestation, the association was borderline (aRR, 0.91; 95% CI, 0.83–1.00). CONCLUSION In our cohort, VLBW preterm infants conceived by ART had an adjusted risk of NDI comparable to that of spontaneously conceived infants.