Risk of Autism Spectrum Disorders in children born after assisted conception. A population based follow-up study.
Résumé
Abstract Objectives: to assess the risk of Autism Spectrum Disorders (ASD) in children born after assisted conception compared to children born after natural conception (NC). Design: population based follow-up study. Setting: all children born alive in Denmark 1995-2003. Participants: 588,967 children born in Denmark from January 1995 to December 2003. Assisted conception was defined as in vitro fertilization (IVF), with or without intracytoplasmic sperm injection (ICSI) and ovulation induction (OI) with or without subsequent insemination. Children exposed to IVF or OI were identified in the IVF Register and in the Danish Drug Prescription Register. Main outcome measures: a diagnosis of Autism Spectrum Disorders in the Danish Psychiatric Central Register. Results: 33,139 (5.6%) of all children born in Denmark 1995-2003 resulted from assisted conception and 225 (0.68%) of these exposed children received an ASD diagnosis. Of the 555,828 NC children born in this period 3,394 (0.61%) received an ASD diagnosis. The follow-up time was 4 to 13 years with a median follow-up time of 9 years. In crude analyses children born after assisted conception had an increased risk of getting an ASD diagnosis, crude hazard rate ratio (HRR) 1.25 (95% CI 1.09-1.43). In analyses adjusting for maternal age, educational level, parity, smoking, birth weight and multiplicity the risk disappeared, adjusted HRR 1.13. (95% CI 0.97-1.31). However, subgroup analyses that suggest possible associations in women who received FSH medications indicate the need for further study. Discussion: this population based follow-up study demonstrated no risk of ASD in children born after assisted conception.
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