Assisted reproductive technology and somatic morbidity in childhood: a systematic review

Objective: To assess whether children conceived by assisted reproductive technology are at increased risk of somatic morbidity in childhood compared with spontaneously conceived children. Design: Systematic review. Setting: None. Patient(s): Children conceived by assisted reproductive technology and reference groups of spontaneously conceived children or children from the background population. Intervention(s): Medline/Pubmed, Embase, and the Cochrane Library were searched as well as reference lists of the retrieved relevant studies. Only cohort studies and case-control studies were included. All studies were scored using the Newcastle-Ottawa scale to assess study quality and the risk of bias in the individual studies. Main Outcome Measure(s): Postneonatal somatic diseases, health care use, chronic illnesses (unspecified), surgery, use of medication, and mortality. Result(s): Thirty-eight studies were included. Results indicated that children conceived by assisted reproductive technology may be at increased risk of unspecified infectious and parasitic diseases, asthma, genitourinary diseases, epilepsy or convulsions, and longer hospitalizations. However, several results in individual studies were not statistically significant and some inconsistency existed between study results. No differences between groups were found regarding hospital admission, outpatient visits, or use of medication. Results regarding mortality, unspecified cancer, pneumonia, allergy, respiratory, and gastrointestinal diseases were contradictory. When considering only the 13 studies allocated the highest score on the Newcastle-Ottawa scale, similar results were found. Conclusion(s): Children conceived by assisted reproductive technology may be at increased risk of somatic morbidity in childhood compared with spontaneously conceived children, although some inconsistency exists between study results. ((c) 2015 by American Society for Reproductive Medicine.)