Long-term cardiometabolic health in people born after assisted reproductive technology: a multi-cohort analysis

Ahmed Elhakeem*, Amy E. Taylor, Hazel M. Inskip, Jonathan Y. Huang, Toby Mansell, Carina Rodrigues, Federica Asta, Sophia M. Blaauwendraad, Siri E. Håberg, Jane Halliday, Margreet W. Harskamp-van Ginkel, Jian Rong He, Vincent W.V. Jaddoe, Sharon Lewis, Gillian M. Maher, Yannis Manios, Fergus P. McCarthy, Irwin K.M. Reiss, Franca Rusconi, Theodosia SalikaMuriel Tafflet, Xiu Qiu, Bjørn O. Åsvold, David Burgner, Jerry K.Y. Chan, Luigi Gagliardi, Romy Gaillard, Barbara Heude, Maria C. Magnus, George Moschonis, Deirdre Murray, Scott M. Nelson, Daniela Porta, Richard Saffery, Henrique Barros, Johan G. Eriksson, Tanja G.M. Vrijkotte, Deborah A. Lawlor

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Scopus)
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Abstract

Aims To examine associations of assisted reproductive technology (ART) conception (vs. natural conception: NC) with offspring cardiometabolic health outcomes and whether these differ with age Methods Differences in systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR), lipids, and hyperglycaemic/insulin resistance and results markers were examined using multiple linear regression models in 14 population-based birth cohorts in Europe, Australia, and Singapore, and results were combined using meta-analysis. Change in cardiometabolic outcomes from 2 to 26 years was examined using trajectory modelling of four cohorts with repeated measures. 35 938 (654 ART) offspring were included in the meta-analysis. Mean age ranged from 13 months to 27.4 years but was <10 years in 11/14 cohorts. Meta-analysis found no statistical difference (ART minus NC) in SBP (−0.53 mmHg; 95% CI:−1.59 to 0.53), DBP (−0.24 mmHg; −0.83 to 0.35), or HR (0.02 beat/min; −0.91 to 0.94). Total cholesterol (2.59%; 0.10–5.07), HDL cholesterol (4.16%; 2.52–5.81), LDL cholesterol (4.95%; 0.47–9.43) were statistically significantly higher in ART-conceived vs. NC offspring. No statistical difference was seen for triglycerides (TG), glucose, insulin, and glycated haemoglobin. Long-term follow-up of 17 244 (244 ART) births identified statistically significant associations between ART and lower predicted SBP/DBP in childhood, and subtle trajectories to higher SBP and TG in young adulthood; however, most differences were not statistically significant Conclusion These findings of small and statistically non-significant differences in offspring cardiometabolic outcomes should reassure people receiving ART. Longer-term follow-up is warranted to investigate changes over adulthood in the risks of hypertension, dyslipidaemia, and preclinical and clinical cardiovascular disease.

Original languageEnglish
Pages (from-to)1464-1473
Number of pages10
JournalEuropean Heart Journal
Volume44
Issue number16
DOIs
Publication statusPublished - 21 Apr 2023

Bibliographical note

Funding:
This project has received funding from the European Research Council
(ERC) under the European Union’s Horizon 2020 research and innovation
programme grant agreement No. 101021566 (ART-HEALTH) and No.
733206 (LifeCycle), the UK Medical Research Council (MC_UU_00011/6), the British Heart Foundation (CH/F/20/90003 and AA/18/1/34219)
and the Bristol National Institute of Health Research Biomedical
Research Centre. Cohort and author specific funding is provided in
Supplementary material online, Text S2.

Publisher Copyright:
© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.

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