Supervisors info:
Σιαχανίδου Σουλτάνα, Αναπληρώτρια Καθηγήτρια, Ιατρική, ΕΚΠΑ
Τζουμάκα- Μπακούλα Χρυσάνθη, Ομότιμη Καθηγήτρια, Ιατρική, ΕΚΠΑ
Κανακά-Gantenbein Χριστίνα, Καθηγήτρια, Ιατρική, ΕΚΠΑ
Summary:
IVF is the most common method of medically assisted reproduction. However, there is concern whether IVF is associated with increased maternal morbidity in pregnancy and their newborns, or an increased risk of neonatal perinatal complications, congenital, chromosomal or other abnormalities, or consequent problems in psychomotor and neurodevelopmental development later in life.
The aim of the present study is to investigate the morbidity and outcome of neonates conceived by assisted reproductive technologies.
In the following paper, the frequency of congenital, chromosomal and other abnormalities, morbidity, thyroid function and renal, liver and bone function, as well as growth and neurodevelopment were compared between neonates conceived by assisted reproductive technologies and neonates naturally conceived.
A total of 324 neonates (108 conceived by assisted reproductive technologies and 216 naturally conceived) who were hospitalized at the Nursing Unit of the First Pediatric Clinic of the University of Athens at the ‘ Ι Agia Sophia’ Childrens’ Hospital, were studied. Information on the medical history of the children was recorded retrospectively, during their hospitalization and during their monitoring in the unit's infant monitoring unit. For the statistical analyses, t-test or Mann-Whitney, x2 controls and multivariate regression analyses were used.
There was no difference in gender between the two groups. In the IVF group, higher percentage of preterm infants (p = 0.001), multiple births (p <0.001), SGA neonates (p = 0.001), congenital abnormalities (p <0.001), and chromosomal abnormalities (p = 0.036) were observed in comparison with the control group.In addition, rates of neonatal morbidity (Respiratory distress syndrome, Patent Ductus Arteriosus, Bronchopulmonary dysplasia, apneas, ROP, infections, NEC, intra-ventricular hemorrhage, hypotension, blood-transfusions or surgery) were higher in the IVF group in comparison with the naturally conceived one. However, morbidity was related to prematurity according to the results of multiple regression analysis. IVF neonates were found to have higher TSH levels in Guthrie test compared to naturally conceived neonates (p=0.02). Furthermore, IVF neonates presented more frequently, in comparison with naturally conceived infants, thyroid dysfunction including hypothyroidism or hypothyroxinemia of prematurity (p<0.001), and hyperthyrotropinemia or subclinical hypothyroidism (p<0.001).
No difference in growth rate or neurodevelopment during the first year of life was observed between groups.
In conclusion, IVF neonates present higher rates of congenital and chromosomal abnormalities neonatal morbidity and thyroid dysfunction in comparison with naturally conceived infants. Follow-up of IVF infants is required for early recognition of abnormalities/dysfunction and appropriate management.
Keywords:
IVF, Neonates, Thyroid function, Congenital abnormalities, Chromosomal abnormalities, Neonatal morbitity
