Published online November 1, 2006
PEDIATRICS Vol. 118 No. 5 November 2006, pp. 1819-1827 (doi:10.1542/peds.2006-0735)
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ARTICLE

Health of Children Born as a Result of In Vitro Fertilization

Reija Klemetti, MHSca, Tiina Sevóna, Mika Gissler, DrPhil, MSocScb and Elina Hemminki, MDa

a Health Services Research
b STAKES Information, STAKES, National Research and Development Centre for Welfare and Health, Helsinki, Finland

OBJECTIVE. The purpose of this study was to use nationwide registries to examine the health of children up to 4 years of age who were born as a result of in vitro fertilization.

METHODS. Children born after in vitro fertilization (N = 4559) from 1996 to 1999 were monitored until 2003. Two control groups were selected from the Finnish Medical Birth Register as follows: all other children (excluding children born after ovulation induction) from the same period (N = 190398, for study of perinatal health and hospitalizations) and a random sample of those children (n = 26877, for study of health-related benefits). Mortality rates and odds ratios for perinatal outcomes, hospitalizations, health-related benefits, and long-term medication use were calculated.

RESULTS. Although the health of most in vitro fertilization children was good, such children had more health problems than other children. A total of 35.7% of in vitro fertilization children and 2.2% of control children were multiple births, and the health of multiple births was worse than that of singletons. Perinatal outcomes of in vitro fertilization children were worse and hospital episodes were more common than among control children. Risks for cerebral palsy and psychological and developmental disorders were increased. Among in vitro fertilization singletons, worse results for perinatal outcomes and hospitalizations, but no increased risk for specific diseases, were found. The health of in vitro fertilization multiple births was comparable to the health of control multiple births.

CONCLUSIONS. Reducing the number of transferred embryos would improve the health of in vitro fertilization children. Additional studies are needed to explain the poorer health of in vitro fertilization singletons, as well as follow-up studies to examine the health of in vitro fertilization children from 4 years onward.

Key Words: in vitro fertilization • perinatal health • morbidity • multiplicity • registry-based study

Abbreviations: CP—cerebral palsy • IVF—in vitro fertilization • HDR—Hospital Discharge Register • MBR—Medical Birth Register • SII—Social Insurance Institution • OR—odds ratio • CI—confidence interval • ICD-10—International Classification of Diseases, 10th Revision

Accepted Jul 11, 2006.




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