Risk of birth defects in children conceived with assisted reproductive technology: A meta-analysis

Background: Although assisted reproductive technology (ART) is extensively used in couples with fertility problems, the risk of birth defects among infants conceived with ART is still a concern. Therefore, to more accurately assess the risk of birth defects after ART treatment, we performed a meta-analysis of all available cohort studies relating to birth defects among infants conceived with ART. Methods: We used an established strategy to search the databases of PUBMED, EMBASE, COCHRANE, WEB OF SCIENCE, CNKI, CBM and VIP for studies published between 2008 and 2020. Subgroup analyses and sensitivity analyses were used to examine sources of heterogeneity. Pooled adjusted odds ratios (ORs) were calculated using a fixed effects model. RevMan5.3 was used to draw a forest plot, and Stata14.0 was used to test for publication bias. Results: We included 14 cohort studies from different countries. The infants conceived with ART had a 1.22-fold higher likelihood of birth defects than children born after natural pregnancy(OR = 1.22, 95% CI [1.17, 1.28], P < .05). The prevalence of birth defects after ART treatment was higher in singleton births than in multiple births. In a meta-analysis of data from 6 studies, we found associations between ART and birth defects related to specifics organs: cardiovascular defects, OR = 1.51, 95% CI [1.34–1.69], P < .05; musculoskeletal defects, OR = 1.09, 95% CI [1.03–1.15], P < .05; urogenital defects, OR = 1.24, 95% CI [1.11–1.38], P < .05; central nervous system defects, OR = 1.33, 95% CI [1.14–1.55], P < .05; and orofacial defects, OR = 1.45, 95% CI [1.15–1.83], P < .05. Conclusions: ART treatment does present an increased risk of birth defects. The prevalence of birth defects after ART treatment is lower in multiple births than in singleton births. Further research is required to examine the risks for birth defects after ART treatment.