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

Elhakeem, A. et al. (2023) Long-term cardiometabolic health in people born after assisted reproductive technology: a multi-cohort analysis. European Heart Journal, 44(16), pp. 1464-1473. (doi: 10.1093/eurheartj/ehac726) (PMID:36740401) (PMCID:PMC10119029)

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 and results: Differences in systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR), lipids, and hyperglycaemic/insulin resistance 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.

• Item Type: Articles
• Additional Information: 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.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Nelson, Professor Scott
• Authors: Elhakeem, A., Taylor, A. E., Inskip, H. M., Huang, J. Y., Mansell, T., Rodrigues, C., Asta, F., Blaauwendraad, S. M., Håberg, S. E., Halliday, J., Harskamp-van Ginkel, M. W., He, J.-R., Jaddoe, V. W.V., Lewis, S., Maher, G. M., Manios, Y., McCarthy, F. P., Reiss, I. K.M., Rusconi, F., Salika, T., Tafflet, M., Qiu, X., Åsvold, B. O., Burgner, D., Chan, J. K.Y., Gagliardi, L., Gaillard, R., Heude, B., Magnus, M. C., Moschonis, G., Murray, D., Nelson, S. M., Porta, D., Saffery, R., Barros, H., Eriksson, J. G., Vrijkotte, T. G.M., and Lawlor, D. A.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: European Heart Journal
• Publisher: Oxford University Press
• ISSN: 0195-668X
• ISSN (Online): 1522-9645
• Published Online: 06 February 2023
• Copyright Holders: Copyright © The Author(s) 2023
• First Published: First published in European Heart Journal 44(16):1464–1473
• Publisher Policy: Reproduced under a Creative Commons License