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Cardiometabolic Differences in Children Born After in Vitro Fertilization: Follow-Up Study

Department of Paediatrics (M.C., M.M.v.W., H.A.D.-v.d.W.), Institute for Clinical and Experimental Neuroscience, and Department of Obstetrics and Gynaecology (J.P.W.V.), VU University Medical Center, 1081 HV Amsterdam, The Netherlands; and Department of Epidemiology (F.E.v.L.), Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands

Address all correspondence and requests for reprints to: Mirjam M. van Weissenbruch, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands. E-mail: m.vanweissenbruch{at}vumc.nl.

Context: Increasing evidence suggests that adverse conditions during early prenatal life are associated with cardiometabolic dysfunction in postnatal life. In vitro fertilization (IVF) conception may be an early prenatal life event with long-term health consequences.

Objective: Our objective was to investigate several cardiometabolic measures in 8- to 18-yr-old IVF singletons and spontaneously conceived controls born from subfertile parents.

Design and Setting: This follow-up study was conducted at the VU University medical center, Amsterdam, The Netherlands.

Participants: Blood pressure was examined in 225 IVF-conceived children and 225 age- and gender-matched spontaneously conceived control children. Several indicators of insulin resistance were studied in a pubertal subpopulation (131 IVF children and 131 controls).

Main Outcome Measures: Blood pressure, fasting glucose, and fasting insulin were determined.

Results: Systolic and diastolic blood pressure levels were higher in IVF children than controls (109 ± 11 vs. 105 ± 10 mm Hg, P < 0.001; and 61 ± 7 vs. 59 ± 7 mm Hg, P < 0.001, respectively). Children born after IVF were also more likely to be in the highest systolic and diastolic blood pressure quartiles (odds ratio = 2.1, 95% confidence interval 1.4, 3.3; odds ratio = 1.9, 95% confidence interval 1.2, 3.0, respectively). Furthermore, higher fasting glucose levels were observed in pubertal IVF children (5.0 ± 0.4 vs. 4.8 ± 0.4 mmol/liter in controls; P = 0.005). Blood pressure and fasting glucose differences could not be explained by current body size, birth weight, and other early life factors or by parental characteristics, including subfertility cause.

Conclusions: These findings highlight the importance of continued cardiometabolic monitoring of IVF-conceived children and might contribute to current knowledge about periconceptional influences and their consequences in later life.

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