Postnatal persistence of fetal cardiovascular remodelling associated with assisted reproductive technologies: a cohort study

Objective To assess the postnatal persistence of fetal cardiovascular remodelling associated with assisted reproductive technologies (ART) in children at 3 years of age. Design A cohort study of children conceived by ART. Setting Maternal‐Fetal Medicine Unit, Hospital Clinic Barcelona, Spain. Popula...

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Bibliographic Details
Published in:BJOG : an international journal of obstetrics and gynaecology 2019-01, Vol.126 (2), p.291-298
Main Authors: Valenzuela‐Alcaraz, B, Serafini, A, Sepulveda‐Martínez, A, Casals, G, Rodríguez‐López, M, Garcia‐Otero, L, Cruz‐Lemini, M, Bijnens, B, Sitges, M, Balasch, J, Gratacós, E, Crispi, F
Format: Article
Language:English
Subjects:
Adult
Age
Assisted reproductive technologies
Blood Pressure
Cardiovascular Diseases - diagnostic imaging
Cardiovascular Diseases - etiology
Carotid Intima-Media Thickness
Case-Control Studies
Child, Preschool
Children
Cohort analysis
Echocardiography
Echocardiography - methods
Female
Fetuses
Heart
Humans
Male
postnatal
Pregnancy
Prospective Studies
Reproductive Techniques, Assisted - adverse effects
Reproductive technologies
Risk Factors
Ultrasonography
Ultrasound
Ventricle
Ventricular Remodeling
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Summary:Objective To assess the postnatal persistence of fetal cardiovascular remodelling associated with assisted reproductive technologies (ART) in children at 3 years of age. Design A cohort study of children conceived by ART. Setting Maternal‐Fetal Medicine Unit, Hospital Clinic Barcelona, Spain. Population sample Eighty singleton pregnancies conceived by ART and 80 spontaneously conceived (controls) followed from fetal life up to childhood. Methods Cardiovascular evaluation was performed at 3 years of corrected age, including echocardiography, carotid intima‐media (cIMT) by ultrasound, and blood pressure. Main outcome measures Postnatal persistence of cardiovascular changes in children conceived by ART. Results Compared with controls, children conceived by ART showed larger atria (right atrial area: control 4.9 cm2 (0.9) versus ART 5.5 cm2 (0.9), P < 0.001), more globular ventricles (right ventricular sphericity index: control mean 1.8 (SD 0.5) versus ART 1.6 (0.2), P < 0.001), and signs of systolic (tricuspid annular plane systolic excursion: control 18 mm (2) versus ART 16 mm (3), P < 0.001) and diastolic dysfunction (isovolumic relaxation time: control 68 ms (12) versus ART 79 ms (12), P < 0.001). ART children also presented increased systolic blood pressure (control 90 mmHg (6) versus ART 94 mmHg (5), P < 0.003) and cIMT (control 0.52 μm (0.14) versus ART 0.60 μm (0.16), P < 0.001) as compared with those spontaneously conceived. Conclusions Cardiovascular changes previously reported in ART fetuses persist postnatally at 3 years of age. These results underscore the importance of future studies for assessing the long‐term cardiovascular health associated with ART. Tweetable Cardiovascular changes described in fetuses conceived by ART, persist in children at 3 years of age. Tweetable Cardiovascular changes described in fetuses conceived by ART, persist in children at 3 years of age.
ISSN:1470-0328
1471-0528
DOI:10.1111/1471-0528.15246