Effects of pregnancy planning fertility and Assisted Reproductive Treatment on child behavioral problems at 5 and 7 years Evidence from the Millennium Cohort Study

Capsule:
Children conceived by ART had higher mean total difficulties scores than planned, naturally conceived children, yet scores mostly remained within the “normal” range, and there was no significant increase in clinically relevant behavioral problems.

Authors:
Claire Carson, Ph.D., Maggie Redshaw, Ph.D., Amanda Sacker, Ph.D., Yvonne Kelly, Ph.D., Jenny J. Kurinczuk, M.D., F.F.P.H., Maria A. Quigley, M.Sc.

Volume 99, Issue 2, Pages 456-463, February 2013

Abstract:

Objective:
To examine the effects of pregnancy planning, time to conception (TTC) and assisted reproductive
technologies (ART) on child behavior.

Design:
Prospective cohort study.

Setting:
Not applicable.

Participants:
A total of 12,380 singletons recruited at 9months, and followed-up at 5 and 7years. Conceptions were
divided into ‘unplanned’ (unplanned, unhappy), ‘mistimed’ (unplanned, happy), ‘planned’ (planned, TTC< 12months), ‘subfertile’ (planned, TTC>12months), ‘ovulation induced’ (received clomiphene citrate), and ‘ART’
(IVF or ICSI).

Interventions:
None.

Outcome:
Child behavior (Strengths and Difficulties Questionnaire).

Results:
Mistimed and unplanned children had higher average SDQ scores at age 5 and 7 years and were significantly more likely to have a clinically relevant behavioral problem compared with the planned group. The ART children had significantly higher average SDQ scores at both 5 and 7 years compared with the planned group. An increase in clinically relevant behavioral problems was observed at 5 years (odds ratio 2.05 [95% confidence interval 0.96, 4.42]) but failed to reach statistical significance. No effects were observed in the subfertile and ovulation-induced groups.

Conclusions:
Unplanned and mistimed children exhibit more behavioral problems than their planned peers. Though ART children have higher mean total difficulties scores, this did not translate into a statistically significant increase in clinically relevant behavioural problems.

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