A US-UK Collaborative Study of the Health of Children Born From In Vitro Fertilization: From Conception Through Young Adulthood

美英合作研究体外受精出生的儿童的健康状况：从受孕到成年

基本信息

批准号：
10749238
负责人：
BARBARA Joan LUKE
金额：
$ 63.46万
依托单位：
BAYLOR COLLEGE OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-01 至 2028-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10749238
关键词：
Accounting Acute Adult Age Assisted Reproductive Technology Authorization documentation Autologous Birth Birth Order Birth Weight Cerebral Palsy Child Child Health Childbirth Childhood Chronic Disease Clinic Collaborations Conceptions Congenital Abnormality Country Data Databases Defect Development Dropout Embryo Embryo Loss Embryo Transfer Embryology Environmental Risk Factor Epigenetic Process Ethnic Origin Fertilization Fertilization in Vitro First Births Follow-Up Studies Growth Health Heart Abnormalities Height Human Individual Infant Intracytoplasmic Sperm Injections Knowledge Left Life Life Cycle Stages Link Lymphocyte Activation Malignant Neoplasms Malignant neoplasm of liver Methodology Morbidity - disease rate Neonatal Neonatal Mortality Neurologic Oocytes Outcome Parents Pattern Perinatal Persons Pregnancy Premature Mortality Procedures Process Race Registries Reporting Research Research Personnel Risk Role Sample Size Siblings Societies Socioeconomic Factors Source Survivors Syndrome System Technology Time Twin Multiple Birth Weight adverse outcome authority early childhood embryo cryopreservation ethnic diversity experience fetal loss follow-up high risk methylome middle childhood mortality neonatal morbidity obesity in children oocyte cryopreservation perinatal outcomes racial diversity respiratory sex young adult

项目摘要

PROJECT SUMMARY Since the birth of the first child from in vitro fertilization (IVF) in the UK in 1978 and in the US in 1981, more than ten million babies have been born from this technology, including more than 1.37 million babies annually worldwide. In 2018, IVF births accounted for 2.24% of all US births and 3.1% of all UK births. Consistent research findings indicate that IVF-conceived pregnancies and IVF-conceived children are at greater risk for a spectrum of adverse perinatal outcomes. A persistent, unresolved issue remains what proportion of the adverse perinatal and child health outcomes after IVF is due to parental factors and what proportion is due to the IVF procedures. In the US, the national IVF database, the Society for Assisted Reproductive Technology Clinic Outcome Reporting System is left-censored at 2004; it is not feasible to obtain data on earlier cycles. In addition, the US has few national databases to facilitate tracking children’s health over time. To overcome these limitations, we are partnering with researchers in the UK in this proposed study. The UK system, under the Human Fertilisation and Embryology Authority, can track individuals treated as early as 1991, linking all adults treated and all children conceived with IVF to a number of national databases. Through this collaboration, we seek to draw upon the strengths of each country: in the UK, longer follow-up and more linked health databases; in the US, more annual IVF cycles and births; and more racial and ethnic diversity. The long-term health of children conceived with IVF is still not clearly understood. Follow-up studies of the growth and health of IVF-conceived children have been limited by small sample sizes, high drop-out rates, and methodological issues, with many knowledge gaps remaining. In this proposed renewal, we are seeking to overcome these limitations using an early life-course approach to evaluate the growth and health of children born from IVF, from conception through childhood, and for the UK component, through adulthood. The two primary aims of this proposed renewal are (1) comprehensively evaluate the role of IVF conception on birth defects, cancer, and the co-occurrence of these conditions through large-scale registry linkages and analysis of the neonatal methylome and (2) to evaluate the effect of IVF treatment parameters, specifically the use of ICSI, number of embryos transferred (embryonic and/or fetal loss as plurality at conception versus at birth), oocyte source/state-embryo state combinations, on child growth (size at birth, and height and weight at ages 4-5 and 10-11) and health (birth defects, cancer, acute and chronic illness, and premature mortality), accounting for parental, socioeconomic, and environmental factors. This proposed study will include a total of more than 4.75 million children, including more than 458,000 IVF- conceived children born 1991-2018, 88,000 naturally-conceived siblings, and 4.2 million naturally-conceived control children, with 80.6 million person-years of follow-up, averaging 14.4 years in the US (ranging from birth to age 22) and 18.3 years in the UK (ranging from birth to age 36), and will provide a comprehensive contemporary picture of child health after conception by in vitro fertilization.

项目概要自 1978 年英国和 1981 年美国第一例体外受精 (IVF) 婴儿出生以来，超过已有1000万婴儿因该技术诞生，其中每年超过137万婴儿 2018年，IVF出生人数占美国出生人数的2.24%，占英国出生人数的3.1%。研究结果表明，体外受精怀孕和体外受精儿童患一系列疾病的风险更大不良围产期结局的比例仍然是一个长期未解决的问题。 IVF 后的儿童健康结果是由父母因素造成的，以及 IVF 程序造成的比例。在美国，国家 IVF 数据库、辅助生殖技术协会临床结果报告系统在 2004 年进行了左审查；无法获取早期周期的数据。很少有国家数据库可以帮助跟踪儿童的长期健康状况。为了克服这些限制，我们。正在与英国的研究人员合作开展这项拟议的研究，该研究是在英国人类受精系统下进行的。和胚胎学管理局，可以追踪早在 1991 年接受治疗的个人，将所有接受治疗的成人和所有儿童联系起来通过这次合作，我们寻求利用 IVF 孕育到许多国家数据库。每个国家的优势：在英国，有更长的随访时间和更多的链接健康数据库；在美国，有更多的年度数据；体外受精周期和出生；以及更多的种族和民族多样性通过体外受精怀孕的孩子的长期健康。 IVF 受孕儿童的生长和健康的后续研究仍不清楚。受样本量小、辍学率高和方法问题的限制，存在许多知识差距在这个拟议的更新中，我们正在寻求利用早期生命历程来克服这些限制。评估体外受精出生的儿童从受孕到童年的生长和健康的方法，以及对于英国部分，到成年期，本次拟议更新的两个主要目标是 (1) 综合评估 IVF 受孕对出生缺陷、癌症以及这些疾病同时发生的作用通过大规模登记联系和新生儿甲基化组分析来确定条件，(2) 评估 IVF 治疗参数的影响，特别是 ICSI 的使用、移植胚胎的数量（胚胎和/或胎儿损失（受孕时与出生时的多数）、卵母细胞来源/状态-胚胎状态组合、儿童生长（出生时的身高、4-5 岁和 10-11 岁时的身高和体重）和健康（出生缺陷、癌症、急性和慢性病和过早死亡），考虑到父母、社会经济和环境因素。这项拟议的研究将总共包括超过 475 万名儿童，其中包括超过 458,000 名 IVF- 1991年至2018年出生的婴儿，88,000名自然受孕的兄弟姐妹，以及420万自然受孕的孩子对照儿童，有 8060 万人年的随访，在美国平均为 14.4 年（从出生到到22岁）和在英国18.3岁（从出生到36岁），并将提供全面的体外受精受孕后儿童健康的当代情况。