A recent study published in JAMA Network Open investigated the relationship between infertility and the risk of autism spectrum disorder (ASD) in children. The study also explored the mediating effects of adverse pregnancy outcomes on this relationship.
ASD is a neurodevelopmental disorder characterized by abnormal brain development. Both genetic and environmental factors play a role in the development of ASD.
Previous research has suggested that children born through assisted reproductive techniques, such as in vitro fertilization (IVF), have a minimal risk of ASD. However, this study aimed to examine the impact of infertility itself, as well as fertility treatments, on ASD risk. It also considered the influence of pregnancy outcomes on this relationship.
The study, conducted in Ontario, Canada, used administrative healthcare data to analyze the records of individuals aged 18 to 55 who had children born between April 1, 2006, and March 31, 2018. Various databases were utilized, including the Better Outcomes Registry and Network (BORN) database of Ontario, which provided information on conception modes and other pregnancy-related data.
The study classified individuals into four groups based on conception mode: unaided conception, subfertility (infertility without fertility treatment), intrauterine insemination (IUI) or ovulation induction (OI), and IVF or intracytoplasmic sperm injections (ICSI). The outcome measure was a diagnosis of ASD in children aged 18 months or older.
The analysis revealed that children born to subfertile parents had a slightly higher risk of ASD compared to those conceived naturally. Similarly, children born following IUI or OI and ICSI or IVF also had a marginally increased ASD risk.
The study also considered the mediating effects of adverse pregnancy outcomes on the relationship between infertility and ASD risk. Factors such as cesarean birth, multiple pregnancies, preterm birth, and severe neonatal morbidities were found to influence the association, particularly in children born through ICSI or IVF.
Overall, the findings from this study suggest that infertility itself may contribute to the higher risk of ASD in children, rather than the specific fertility treatments. Future efforts should focus on reducing the occurrence of multiple pregnancies in assisted reproductive techniques and providing tailored care for subfertile individuals receiving fertility treatment.
FAQ
What is autism spectrum disorder (ASD)?
ASD is a neurodevelopmental disorder characterized by abnormal brain development. It affects social interaction, communication, and behavior.
What are the risk factors for ASD?
Both genetic and environmental factors play a role in the development of ASD. Maternal metabolic and inflammatory variables, as well as offspring epigenetic alterations, are considered prenatal risk factors.
What were the findings of the study?
The study found that children born to subfertile parents, as well as those born following IUI or OI and ICSI or IVF, had a slightly higher risk of ASD compared to those conceived naturally. Adverse pregnancy outcomes, such as cesarean birth, multiple pregnancies, preterm birth, and severe neonatal morbidities, were also associated with increased ASD risk, particularly in children born through ICSI or IVF.
What does this mean for future research and treatment?
The study suggests that underlying infertility may be a contributing factor to the higher risk of ASD in children, rather than the specific fertility treatments. Efforts should be made to reduce the occurrence of multiple pregnancies in assisted reproductive techniques, and tailored care should be provided for subfertile individuals receiving fertility treatment. Further research is needed to better understand the relationship between infertility and ASD risk and to develop targeted interventions for at-risk populations.