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Birth defects in medically assisted reproduction pregnancies in the city of Barcelona

Authors

  • Rosa Gutarra-Vilchez,

    1. Vitarte Hospital MINSA, Lima, Lima, Peru
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  • Elena Santamariña-Rubio,

    1. Servei de Sistemes d'Informació Sanitària (SESIS). Agència de Salut Pública de Barcelona, CIBER Epidemiología y Salud Pública (CIBERESP), Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Barcelona, Spain
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  • Joaquin Salvador,

    1. Servei de Sistemes d'Informació Sanitària (SESIS). Agència de Salut Pública de Barcelona, CIBER Epidemiología y Salud Pública (CIBERESP), Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Barcelona, Spain
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  • Antoni Borrell

    Corresponding author
    1. Department of Maternal–Fetal Medicine, Hospital Clinic de Barcelona, Barcelona, Catalonia, Spain
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  • Funding sources: None

  • Conflicts of interest: None declared

ABSTRACT

Objective

To assess the association between the use of medically assisted reproduction (MAR) and birth defects (BD) in newborns and terminations of pregnancy in pregnant women registered in Barcelona in the period 1992 to 2007.

Methods

We studied 1905 cases and 2722 controls in a retrospective population-based case–control study. Cases comprised any newborn presenting at least one major BD, as well as any pregnancy terminated because of BD. Controls were newborns without BD. Exposure was MAR. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) were calculated by means of logistic regression to assess the association.

Results

The MAR was demonstrated to be associated with BD, after adjusting for probable confounders (aOR = 1.8; 95% CI = 1.4 to 2.5). Regarding MAR modalities, this association was statistically significant only for assisted reproduction techniques (ART) (aOR = 2.7; 95% CI = 1.8 to 4.1). In the stratified analysis by structural BD categories, frequencies for all categories were increased after ART with the exception of head-face-neck-eye defects, none after artificial insemination, and digestive-abdominal wall defects in ovulation induction.

Conclusions

This study demonstrated a strong association between ART and BD, with an almost threefold increased risk for overall BD after ART, as compared with natural conception. Increased associations were also observed for almost all structural BD categories. © 2013 John Wiley & Sons, Ltd.

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