Children born by assisted reproductive technology at higher risk of childhood cancer: JAMA

TAIWAN: A Taiwanese population-based cohort study published in JAMA has found that children born via the use of assisted reproductive technology (ART) may be at an increased risk of acquiring childhood malignancies.

It has become more common to have children through the use of assisted reproductive technologies (ART). These children could be more likely to experience epigenetic changes and unfavorable prenatal outcomes, which could lead to childhood malignancies. There is currently conflicting research regarding the link between ART conception and pediatric malignancies.

"There has never been a study that looked at how prenatal outcomes affect the link between the mode of conception and childhood malignancies", the authors wrote.

The authors aimed to ascertain the correlations between various methods of conception and childhood malignancies, as well as any potential roles that preterm birth and low birth weight may play in mediating these relationships.

For this study, the authors analyzed registry information on 2,308,016 Taiwanese eligible parent-child triads from January 2004 to December 2017. The mean ages of the fathers and mothers were 33.3 and 30.8 respectively. 52.1% of the kids were boys, 8.2% of them were born prematurely, and 7.4% had low birth weights. There were 1,880 children with childhood cancer in total.

Key findings of the study:

• During 14.9 million person-years of follow-up (median, 6 years), ART conception was linked to a higher risk of any type of childhood cancer than natural conception (hazard ratio, 1.58); subfertility was linked to a higher risk of childhood cancers than non-ART conception (hazard ratio, 1.42).
• Leukemia and hepatic tumors were the main causes of the elevated cancer risk in children born through ART.
• Preterm birth or low birth weight did not play a role in the elevated cancer risk linked to ART conception.

"It is still unknown if the elevated risk is linked to particular ART techniques, specific fertility medications, or the underlying infertility of the parents. This information will be crucial for improving our knowledge of childhood cancer and developing strategies for prevention", added the researchers.

The authors concluded that compared to spontaneously conceived children, children born to parents with an infertility diagnosis had a greater chance of developing childhood malignancies. Preterm birth or low birth weight were unable to account for the elevated risk, they wrote.

REFERENCE

Weng SS, Huang YT, Huang YT, Li YP, Chien LY. Assisted Reproductive Technology and Risk of Childhood Cancers. JAMA Netw Open. 2022 Aug 1;5(8):e2230157. doi: 10.1001/jamanetworkopen.2022.30157. PMID: 36044210.