1
|
Wei SQ, Luu TM, Ayoub A, Lewin A, Auger N. Assisted Reproductive Technology During COVID-19: A Population-Based Study Of Pregnancy Outcomes. Reprod Sci 2024:10.1007/s43032-024-01649-x. [PMID: 39030447 DOI: 10.1007/s43032-024-01649-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 07/09/2024] [Indexed: 07/21/2024]
Abstract
We assessed the impact of the COVID-19 pandemic on the pregnancy outcomes of patients who used assisted reproductive technology. We conducted a population-based cohort study of 443,101 patients who conceived naturally or with assisted reproductive technology between December 2015 and July 2021 and had a delivery in hospitals of Quebec, Canada. The main exposure measure was use of assisted reproductive technology before or during the pandemic. Outcomes included preeclampsia, preterm birth, and other pregnancy complications. We used adjusted log-binomial regression models to estimate risk ratios (RR) and 95% confidence intervals (CI) for the association of assisted reproductive technology with adverse pregnancy outcomes compared with natural conception before vs. during the pandemic. In secondary analyses, we examined the association of COVID-19 infection with pregnancy outcomes among women who used assisted reproductive technology. Compared with natural conception, assisted reproductive technology was associated with an increased risk of preeclampsia (RR 1.43; 95% CI 1.21-1.68), preterm birth (RR 2.07; 95% CI 1.84-2.33), and low birth weight (RR 1.94; 95% CI 1.72-2.20) during the pandemic. However, the same risks were also present before the pandemic. Compared with no infection, COVID-19 infection was not associated with adverse outcomes among women who conceived with assisted reproductive technology. This study suggests that the COVID-19 pandemic did not significantly impact the pregnancy outcomes of women who underwent assisted reproductive procedures in Quebec. The findings are reassuring for patients concerned about the potential reproductive effects of the pandemic.
Collapse
Affiliation(s)
- Shu Qin Wei
- Department of Obstetrics and Gynecology, University of Montreal, Montreal, QC, Canada
- Institut national de santé publique du Québec, Montreal, QC, Canada
| | - Thuy Mai Luu
- Department of Pediatrics, Sainte-Justine Hospital Research Centre, University of Montreal, Montreal, QC, Canada
| | - Aimina Ayoub
- Institut national de santé publique du Québec, Montreal, QC, Canada
- University of Montreal Hospital Research Centre, Montreal, QC, Canada
| | - Antoine Lewin
- Department of Obstetrics and Gynecology, Sherbrooke University, Sherbrooke, QC, Canada
| | - Nathalie Auger
- Institut national de santé publique du Québec, Montreal, QC, Canada.
- University of Montreal Hospital Research Centre, Montreal, QC, Canada.
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, QC, Canada.
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
| |
Collapse
|
2
|
Zhu H, Xu J, Cai J, Liu H, Zhao Z, Chen T, Wang P, Zhou L, Chen Y, He D, Zhao Y, Ji L. Cohort Profile: The Ningbo Birth Cohort of Population Undergoing Assisted Reproductive Technology (NBart). Int J Epidemiol 2024; 53:dyae086. [PMID: 39038497 DOI: 10.1093/ije/dyae086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 06/22/2024] [Indexed: 07/24/2024] Open
Affiliation(s)
- Hui Zhu
- Department of Internal Medicine, Health Science Center, Ningbo University, Ningbo, Zhejiang, P. R. China
| | - Jin Xu
- School of Public Health, Health Science Center, Ningbo University, Ningbo, Zhejiang, P. R. China
- Zhejiang Key Laboratory of Pathophysiology, Health Science Center, Ningbo University, Ningbo, Zhejiang, P. R. China
| | - Jie Cai
- Center for Reproductive Medicine, Ningbo Women and Children's Hospital, Ningbo, Zhejiang, P. R. China
| | - Hongyi Liu
- School of Public Health, Health Science Center, Ningbo University, Ningbo, Zhejiang, P. R. China
| | - Zhijia Zhao
- Department of Medical Records and Statistics, Affiliated People's Hospital of Ningbo University, Ningbo, Zhejiang, P. R. China
| | - Tao Chen
- School of Public Health, Health Science Center, Ningbo University, Ningbo, Zhejiang, P. R. China
| | - Penghao Wang
- School of Public Health, Health Science Center, Ningbo University, Ningbo, Zhejiang, P. R. China
| | - Liming Zhou
- Center for Reproductive Medicine, Ningbo Women and Children's Hospital, Ningbo, Zhejiang, P. R. China
| | - Yanming Chen
- Department of Medical Records and Statistics, Beilun People's Hospital, Ningbo, Zhejiang, P. R. China
| | - Da He
- Department of Obstetrics and Gynecology, Yinzhou District Maternal and Child Health Care Institute, Ningbo, Zhejiang, P. R. China
| | - Yiming Zhao
- Department of Obstetrics and Gynecology, Jiangbei District Maternal and Child Health Care Institute, Ningbo, Zhejiang, P. R. China
| | - Lindan Ji
- Zhejiang Key Laboratory of Pathophysiology, Health Science Center, Ningbo University, Ningbo, Zhejiang, P. R. China
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Health Science Center, Ningbo University, Ningbo, Zhejiang, P. R. China
| |
Collapse
|
3
|
Wei SQ, Paradis G, Ayoub A, Lewin A, Auger N. Assisted Reproductive Technology and Cardiovascular Outcomes in Parents and Offspring. Can J Cardiol 2024; 40:130-137. [PMID: 37722625 DOI: 10.1016/j.cjca.2023.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 09/08/2023] [Accepted: 09/12/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND The impact of assisted reproductive technology (ART) on the cardiovascular system is unclear. METHODS We conducted a retrospective longitudinal cohort study of 1,001,593 pregnancies conceived naturally or through ART from 2008 to 2019 in Québec to assess the association of ART with cardiovascular disease in families. The exposure measure was ART. The outcome included severe maternal cardiovascular morbidity, congenital heart defects in offspring, and long-term risk of cardiovascular hospitalisation in mothers, fathers, and offspring during 11 years of follow-up. We estimated the association between ART and cardiovascular outcomes with the use of adjusted log-binomial regression (risk ratio, 95% confidence interval [CI]) and Cox proportional hazards regression models (hazard ratio [HR]). RESULTS Compared with natural conception, ART was associated with 2.04 times the risk of severe cardiovascular morbidity in mothers (95% CI 1.86-2.23) and 1.38 times the risk of congenital heart defects in offspring (95% CI 1.26-1.50). ART was not associated with the risk of maternal cardiovascular hospitalisation following pregnancy (HR 1.03, 95% CI 0.88-1.21). However, ART was associated with an increased risk of paternal cardiovascular hospitalisation (HR 1.24, 95% CI 1.11-1.38) and offspring cardiovascular hospitalisation (HR 1.27, 95% CI 1.01-1.61), mainly due to an increased risk of hypertension. CONCLUSIONS ART is associated with only a small increase in the risk of cardiovascular complications in families. Parents and offspring may be reassured that ART likely has no major impact on the cardiovascular system.
Collapse
Affiliation(s)
- Shu Qin Wei
- Department of Obstetrics and Gynaecology, University of Montréal, Montréal, Québec, Canada; Institut national de santé publique du Québec, Montréal, Québec, Canada
| | - Gilles Paradis
- Institut national de santé publique du Québec, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Aimina Ayoub
- Institut national de santé publique du Québec, Montréal, Québec, Canada; University of Montréal Hospital Research Centre, Montréal, Québec, Canada
| | - Antoine Lewin
- Department of Obstetrics and Gynaecology, University of Sherbrooke, Sherbrooke, Québec, Canada; Medical Affairs and Innovation, Héma-Québec, Montréal, Québec, Canada
| | - Nathalie Auger
- Institut national de santé publique du Québec, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada; University of Montréal Hospital Research Centre, Montréal, Québec, Canada; Department of Social and Preventive Medicine, School of Public Health, University of Montréal, Montréal, Québec, Canada.
| |
Collapse
|
4
|
DNA Methylation in Offspring Conceived after Assisted Reproductive Techniques: A Systematic Review and Meta-Analysis. J Clin Med 2022; 11:jcm11175056. [PMID: 36078985 PMCID: PMC9457481 DOI: 10.3390/jcm11175056] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/09/2022] [Accepted: 08/23/2022] [Indexed: 11/17/2022] Open
Abstract
Background: In the last 40 years, assisted reproductive techniques (ARTs) have emerged as potentially resolving procedures for couple infertility. This study aims to evaluate whether ART is associated with epigenetic dysregulation in the offspring. Methods. To accomplish this, we collected all available data on methylation patterns in offspring conceived after ART and in spontaneously conceived (SC) offspring. Results. We extracted 949 records. Of these, 50 were considered eligible; 12 were included in the quantitative synthesis. Methylation levels of H19 CCCTC-binding factor 3 (CTCF3) were significantly lower in the ART group compared to controls (SMD −0.81 (−1.53; −0.09), I2 = 89%, p = 0.03). In contrast, H19 CCCTC-binding factor 6 (CTCF6), Potassium Voltage-Gated Channel Subfamily Q Member 1 (KCNQ1OT1), Paternally-expressed gene 3 (PEG3), and Small Nuclear Ribonucleoprotein Polypeptide N (SNRPN) were not differently methylated in ART vs. SC offspring. Conclusion: The methylation pattern of the offspring conceived after ART may be different compared to spontaneous conception. Due to the lack of studies and the heterogeneity of the data, further prospective and well-sized population studies are needed to evaluate the impact of ART on the epigenome of the offspring.
Collapse
|
5
|
Hwang SS. Assisted reproductive technology and childhood morbidity: How should we measure the risk and what amount of risk is meaningful? Fertil Steril 2022; 118:369-370. [PMID: 35786306 DOI: 10.1016/j.fertnstert.2022.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 06/14/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Sunah S Hwang
- Division of Neonatology, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
| |
Collapse
|