Association between being large for gestational age and cardiovascular metabolic health in children conceived from assisted reproductive technology: a prospective cohort study

• Published in: BMC medicine 2024-05, Vol.22 (1), p.203-12, Article 203
• Main Authors: Zhang, Yiyuan, Dai, Kexin, Chen, Xiaojing, Cui, Linlin, Chen, Zi-Jiang
• Format: Article
• Language: English
• Subjects: Age; Analysis; Assisted reproductive technology; Birth weight; Birth Weight - physiology; Blood pressure; Blood sugar; Body Mass Index; Body size; Cardiovascular Diseases - epidemiology; Cardiovascular metabolic health; Care and treatment; Child; Child, Preschool; Children; China - epidemiology; Congenital diseases; Demographic aspects; Diabetes; Diagnosis; Education; Embryos; Families & family life; Fasting; Female; Gestational Age; Glucose; Health aspects; High density lipoprotein; Hospitals; Humans; Hyperlipidemia; Hypertension; Infant; Infant, Newborn; Insulin; Insulin resistance; Insulin Resistance - physiology; Large for gestational age; Male; Mediation; Metabolic disorders; Obesity; Obesity in children; Offspring; Parents & parenting; Pregnancy; Prospective Studies; Puberty; Reproductive health; Reproductive Techniques, Assisted; Reproductive technologies; Reproductive technology; Socioeconomic factors; Standard scores; Tobacco; Variables
• ISSN: 1741-7015; 1741-7015
• DOI: 10.1186/s12916-024-03419-7

To the best of our knowledge, no study has investigated the potential joint effect of large for gestational age (LGA) and assisted reproductive technology (ART) on the long-term health of children. This was a prospective cohort study that recruited children whose parents had received ART treatment in the Center for Reproductive Medicine, Shandong Provincial Hospital, affiliated to Shandong University, between January 2006 and December 2017. Linear mixed model was used to compare the main outcomes. The mediation model was used to evaluate the intermediary effect of body mass index (BMI). 4138 (29.5%) children born LGA and 9910 (70.5%) children born appropriate for gestational age (AGA) were included in the present study. The offspring ranged from 0.4 to 9.9 years. LGAs conceived through ART were shown to have higher BMI, blood pressure, fasting blood glucose, fasting insulin, and homeostatic model assessment of insulin resistance values, even after controlling for all covariates. The odds of overweight and insulin resistance are also higher in LGA subjects. After adjusting for all covariates, LGAs conceived through ART had BMI and BMI z-scores that were 0.48 kg/m and 0.34 units greater than those of AGAs, respectively. The effect of LGA on BMI was identified as early as infancy and remained consistently significant throughout pre-puberty. Compared to AGA, LGA children conceived from ART were associated with increased cardiovascular-metabolic events, which appeared as early as infancy and with no recovery by pre-puberty.