Are children born after assisted reproductive technology at increased risk of autism spectrum disorders? A systematic review

Traduction partielle: G.M.

Hum Reprod. 2013 Oct 15.

Les enfants nés après procréation médicalement assistée (ART) sont-ils à risque accru de troubles du spectre autistique ?:  Une revue systématique

Conti E, Mazzotti S, Calderoni S, Saviozzi I, Guzzetta A.

Source

Department of Developmental Neuroscience, IRCCS Stella Maris, Via dei Giacinti 2, 56128 Calambrone, Pisa, Italy.

Abstract

STUDY QUESTION:

Are children born after assisted reproductive technology (ART) at increased risk of autism spectrum disorders (ASD)?

SUMMARY ANSWER:

Il n'existe aucune preuve que l'ART augmente significativement le risque de TSA chez les enfants.

WHAT IS KNOWN ALREADY:

A few systematic reviews have explored the correlation between assisted conception and ASD with inconclusive results, partly due to the heterogeneity of diagnostic criteria and methodology in the different studies.

STUDY DESIGN, SIZE, DURATION:

Systematic review of 7 observational studies (2 cohort and 5 case-control) encompassing 9216 subjects diagnosed with ASD published since 2000.

MATERIALS, SETTING, METHODS:

Literature searches were conducted to retrieve observational studies on the risk of ASD in ART population. Databases searched included PubMed, EMBASE and PsycINFO. In order to obtain more consistent results, we only included the studies in which (i) subjects with either infantile autism or ASD could be identified according to international classification systems and (ii) the diagnosis was obtained from hospital records. Seven studies matched the inclusion criteria.

MAIN RESULTS AND THE ROLE OF CHANCE:

Four out of seven studies, including the two with the best quality scores, did not show an association between ART and ASD. The two papers supporting an increased risk of autism following ART had the lowest quality scores, due to major methodological limitations. Only one paper showed a protective role of ART.

LIMITATIONS, REASONS FOR CAUTION:

In spite of the strict inclusion criteria applied as to the diagnosis of ASD, the papers selected are heterogeneous in many aspects including study design, definitions of ART, data source and analysed confounders.

WIDER IMPLICATIONS OF THE FINDINGS:

À l'heure actuelle , il n'existe aucune preuve que l'art est significativement associée à la TSA et donc que les politiques de santé actuels doivent être modifiés.  
Les résultats divergents de certaines études suggèrent que d'autres études prospectives , large et haute qualité sont encore nécessaires.

STUDY FUNDING/COMPETING INTEREST(S):

This work was supported, in part, by the Italian Ministry of Health and by Tuscany Region. The authors have no competing interests to declare. TRIAL REGISTRATION NUMBER: N/A.

PMID: 24129612