Danish Medical Bulletin - No. 3. August 2009. Vol. 56 Page 176

ABSTRACT OF DISSERTATION

The risk of cerebral palsy and autism in children born after assisted conception

Dorte Hvidtjørn, Midwife, Master of Public Health

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This PhD dissertation was accepted by the Faculty of Health Sciences of the University of Aarhus, and was defended on June 26, 2009.

Official opponents: Tine Brink Henriksen, Morten Hedegaard, and Ulla-Britt Wennerholm, Sweden.

Tutors: Poul Thorsen, Jakob Grove, and Bo Jacobsson, Sweden.

Correspondence: Dorte Hvidtjørn, Paludan-Müllers Vej 17, 8000 Århus, Denmark

E-mail dh@soci.au.dk

ABSTRACT

The PhD project was carried out at the School of Public Health, the University of Aarhus, and the aim was to assess the risk of cerebral palsy (CP) and autism in children born after assisted conception, that is in vitro fertilization (IVF) as well as ovulation induction without IVF. The study was a follow-up study including all children born in Denmark from 1995 to 2003, 588.967 children, and based on the following Danish registers: the Medical Birth Register, the IVF Register, the Danish Drug Prescription Register, the National Cerebral Palsy Register containing validated CP diagnoses and the Danish Psychiatric Central Research Register.

We found an increased risk of CP in children born after assisted conception in crude analyses, relative risk (RR) 1.92 (95% confidence interval (CI) 1.60-2.31) and when we adjusted for sex, maternal age, parity, educational level and smoking during pregnancy RR 1.74 (95% CI 1.42-2.13). When we included the intermediate factors multiplicity and preterm delivery, the risk for CP after assisted conception disappeared, RR 0.97 (95% CI 0.78-1.22).

The risk of autism in children born after assisted conception was also increased, crude hazard rate ratio (HRR) 1.25 (95% CI 1.09-1.43). In a stratum of children with normal birth weight, the risk remained statistically significant when we adjusted for sex, maternal age, parity, educational level, smoking during pregnancy and multiplicity, HRR 1.20 (95% CI 1.02-1.41).

In can be concluded that for autism the increased risk in assisted conception was not explained by multiplicity and preterm delivery as seemed to be the case for CP.
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