RESUMO
Background: Multiple pregnancies occur more frequently in assisted reproductive technology [ART] compared to normal conception [NC]. It is known that the risk of congenital malformations in a multiple pregnancy are higher than single pregnancy. The aim of this study is to compare congenital malformations in singleton infants conceived by ART to singleton infants conceived naturally
Materials and Methods: In this historical cohort study, we performed a historical cohort study of major congenital malformations [MCM] in 820 singleton births from January 2012 to December 2014. The data for this analysis were derived from Tehran's ART linked data file. The risk of congenital malformations was compared in 164 ART infants and 656 NC infants. We performed multiple logistic regression analyses for the independent association of ART on each outcome
Results: We found 40 infants with MCM 29 [4.4%] NC infants and 14 [8.3%] ART infants. In comparison with NC infants, ART infants had a significant 2-fold increased risk of MCM [P=0.046]. After adjusting individually for maternal age, infant gender, prior stillbirth, mother's history of spontaneous abortion, and type of delivery, we did not find any difference in risk. In this study the majority [95.1%] of all infants were normal but 4.9% of infants had at least one MCM. We found a difference in risk of MCMs between in vitro fertilization [IVF] and intracytoplasmic sperm injection [ICSI]. We excluded the possible role of genotype and other unknown factors in causing more malformations in ART infants
Conclusion: This study reported a higher risk of MCMs in ART singleton infants than in NC singleton infants. Congenital heart disease, developmental dysplasia of the hip [DDH], and urogenital malformations were the most reported major malformations in singleton ART infants according to organ and system classification
RESUMO
Objective: Nowadays, many infertile couples can have child by assistant reproductive technology [ART]. Always the undesirable effects of these methods on newborn are considered and are evaluated. The aim of this study is to describe the impact of ART on ocular and visual performances of infants born by these methods
Materials and methods: In a cross sectional descriptive study, 479 infants aged three-nine months presented to an optometry clinic of Child Health and Development Research Department [CHDRD], Tehran, Iran. Static retinoscopy, qualitative fixation evaluation, Hirschberg test, red reflex assessment and external eye examination were carried out. Other information such as birth weight and maturity of the infants was recorded
Results: It was possible to assess only 320 out of 479 infants due to general condition of some participants. Comparison of mean refractive error in infants' right and left eyes did not show any significant difference. Our findings confirmed that 20.3% had poor fixation, while 2,9% revealed manifest strabismus. The results also revealed the prevalences of myopia, hyperopia and emmetropia are 2.9%, 87%, and 10.1%, respectively. Red reflex abnormalities were significantly found in boys and in preterm infants [p<0.05]. Failure of fixation control was seen more frequently with increasing refractive error, which significantly developed in preterm infants [p<0.001]
Conclusion: These results reflect the necessity of more comprehensive assessments and further follow-up of infants born by ART, especially for premature male ART infants. These results also suggest the probability of fixation condition and visual deficiencies in these infants. It is recommended to pay close attention to this preliminary report about the refractive and fixation condition of the infants born after ART