Long-term pediatric gastrointestinal morbidity of singletons conceived following fertility treatments

Avi Harlev, Tamar Wainstock, Asnat Walfisch, Idit Segal, Daniella Landau, Eyal Sheiner

Research output: Contribution to journalMeeting Abstract


The prevalence of pregnancies conceived following fertility treatments is increasing worldwide. While the impact on perinatal outcome is well established, the long-term consequences on offspring health are yet to be determined. We aimed to study the association between mode of conception and long-term gastrointestinal morbidity among children born following fertility treatments including in-vitro fertilization (IVF) and ovulation induction (OI).

Study Design
A population-based cohort analysis was performed including all singleton deliveries occurring between 1991-2014 at a single regional tertiary medical center. Fetuses with congenital malformations were excluded. A comparison was performed between children delivered following IVF, OI and spontaneous pregnancies. Hospitalizations up to the age of 18 years involving gastrointestinal morbidity were evaluated. Kaplan-Meier survival curve was used to compare cumulative morbidity incidence. A Cox regression model was used to control for confounders.

During the study period 242,187 singleton deliveries met the inclusion criteria; 1.1% were following IVF (n=2603), and 0.7% occurred following OI (n=1721). Hospitalization rates up to the age of 18 years involving gastrointestinal morbidity were significantly more common in children conceived following IVF and OI (5.7%, 7.1% respectively) as compared with those conceived spontaneously (5.4%; p=0.05). Selected gastrointestinal morbidities are presented in the Table. The Kaplan-Meier survival curve demonstrated a significantly higher cumulative incidence of gastrointestinal morbidity following IVF and OI (Figure, log rank p=0.001). Using the Cox proportional hazards model, controlled for maternal age, preterm delivery, birthweight, maternal diabetes and hypertensive disorders in pregnancy, IVF (adjusted HR=1.27, CI 1.08-1.49, p=0.004), but not OI (adjusted HR=1.19, CI 0.99-1.42, p=0.054), was noted as independent risk factors for long-term pediatric gastrointestinal morbidity.

Singletons conceived by IVF appear to be at an increased risk for long-term gastrointestinal morbidity.
Original languageEnglish GB
Pages (from-to)S436-S437
JournalAmerican Journal of Obstetrics and Gynecology
Issue number1
StatePublished - Jan 2018


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