American Journal of Epidemiology, Vol 152, Issue 9 823-828, Copyright © 2000 by Oxford University Press
D Whiteman, M Murphy, K Hey, M O'Donnell and M Goldacre
Periconceptual exposure to subfertility treatments is increasingly common,
raising concerns about the possibility of malformations in the offspring.
The authors conducted a case-control study to determine whether
subfertility or its treatment was associated with increased risk of neural
tube defects (NTDs). Cases were 694 women diagnosed with an NTD-affected
pregnancy in Oxfordshire or West Berkshire, England, between 1970 and 1987.
Cases were individually matched on maternal year of birth and year of index
pregnancy to controls randomly selected from a computerized database. Data
on demographic, reproductive, and obstetric factors were abstracted from
patient hospital records. Overall, the period prevalences of subfertility
and of subfertility treatment were 7% and 3%, respectively, No evidence was
found that the risk of NTD-affected pregnancies was increased by either
subfertility (odds ratio (OR) = 1.2, 95% confidence interval (CI): 0.7,
2.1) or its treatment (OR = 0.9, 95% CI: 0.4, 2.0). After adjustment,
NTD-affected pregnancies were associated with female offspring (OR = 2.3,
95% CI: 1.8, 3.1), multiple birth (OR = 4.8, 95% CI: 1.2, 18.8), and higher
numbers of pregnancies (p for trend = 0.005). The findings from this large,
population-based study were wholly consistent with those from smaller
studies that found no increased risk of NTD associated with exposure to
fertility treatments but reported associations with various pregnancy
outcomes.
Reproductive factors, subfertility, and risk of neural tube defects: a case-control study based on the Oxford Record Linkage Study Register [In Process Citation]
Imperial Cancer Research Fund General Practice Research Group, Institute of Health Sciences, University of Oxford, United Kingdom.
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