Fertility treatment does not adversely affect cardiovascular health of offspring, international study suggests
raises cardiovascular disease risk, the differences we found were small and did not persist to young adulthood.
Strengths of this study include the large sample size in comparison with previous studies and the inclusion of cohorts from different geographic regions, which should make the findings generalizable to ART pregnancies from various countries.
Study limitations include the low precision/power for some outcomes even with this large collaboration. Most cohorts were young which meant we were unable to examine results by age groups and could only do trajectory analyses in a subgroup of the included cohorts. Whilst our analyses were adjusted for pre-specified confounders, residual confounding by parental health conditions and other unmeasured factors is possible.
Our analysis of all cohorts was restricted to offspring with complete data on mode of conception, confounders, and outcomes which may have reduced precision of estimates and introduced a bias due to missing data.
We explored if our findings could be due to multiple births by examining associations in singletons only and did not examine associations separately in multiple births because this would be underpowered, and likely to be less relevant to current and future generations given the declining prevalence of multiple pregnancy with ART.Mediation through offspring birth weight, gestational age, and BMI was examined by adjusting for these characteristics.
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