Observed Prevalence and Predictors of Congenital Heart Disease in Infants Conceived via In vitro Fertilization

Q: What are the key findings of this study?

In vitro fertilization was associated with an observed prevalence of any congenital heart disease of 4.76%, which was significantly higher than the 1% general population baseline.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Congenital heart disease (n=1890). Intervention: In vitro fertilization (IVF) vs. General population baseline. Primary outcome: Any structural congenital heart disease (CHD) (p=<0.05).

Q: What does this research mean for the field?

Infants conceived via in vitro fertilization have an increased prevalence of congenital heart disease (4.76% compared to the ~1% general population baseline), with the burden largely driven by less severe forms. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To quantify congenital heart disease prevalence across severity subtypes and identify independent clinical and demographic predictors in an exclusively in vitro fertilization-conceived population.

Calista Dominy; Eric Takoushian; Kevin Strobino; Denis J. Donovan; Sheila J. Carroll

doi:10.1007/s00246-026-04406-w

August 1, 2026Pediatric CardiologyOpen Access

Observed Prevalence and Predictors of Congenital Heart Disease in Infants Conceived via In vitro Fertilization

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Key result

IVF linked to a ~376% higher CHD prevalence versus the general population.

P<0.05
n=1,890

Why the study?

Infants conceived via IVF have reported increased rates of CHD, but estimates and associated risk factors remain variable.

Does in vitro fertilization conception increase congenital heart disease in infants?

Key Points

To quantify congenital heart disease prevalence across severity subtypes and identify independent clinical and demographic predictors in an exclusively in vitro fertilization-conceived population.
Analyzed a retrospective cohort of 1890 IVF-conceived infants from 1783 mothers at a single tertiary academic center between 2020 and 2025.
Categorized outcomes into any CHD, persistent CHD (not resolved within 3 years), and significant CHD (requiring medical or procedural intervention), comparing rates to the ~1% general population baseline using Proportion Z tests.
Identified independent predictors via multivariable logistic regression and completed sensitivity analyses excluding cases with established CHD risk factors.
Observed CHD prevalence was 4.76% for any CHD, 3.33% for persistent CHD, and 1.64% for significant CHD (all p<0.05 compared with the 1% general population baseline).
Excluding established CHD risk factors decreased prevalence to 3.1% for any, 2.1% for persistent, and 1.01% for significant CHD (p=0.98 vs. baseline for significant CHD).
Maternal hypertension, Black race, and Asian race independently predicted any CHD (p<0.05), whereas only maternal hypertension predicted persistent CHD (p<0.05) and only twin gestation predicted significant CHD (p<0.05).

Study Design

Type

Cohort (n=1,890)

Multicenter

No

Structured PICO

Does in vitro fertilization conception increase congenital heart disease in infants?

P

Population

1,890 IVF-conceived infants (mean maternal age 38.3 years) born at a single tertiary academic center between 2020 and 2025, evaluated for the prevalence and predictors of congenital heart disease.

E

Exposure

In vitro fertilization (IVF) conception

C

Comparator

General population baseline prevalence (~1%)

O

Outcome

Any structural congenital heart disease (excluding patent foramen ovale and patent ductus arteriosus)hard clinical

Main Result

Absolute Event Rate: 4.76% vs 1%

p-value: p=<0.05

Limitations

Single-center design in an urban, high-income population may limit generalizability.
Retrospective data collection introduces potential for misclassification and missing clinical information.
Differential utilization of fetal and postnatal echocardiography in IVF pregnancies may lead to surveillance bias and overestimate the prevalence of milder lesions.
Exclusion of cases involving termination or fetal demise may underestimate the prevalence of significant CHD.
Analyses performed at the infant level included multiple infants from multifetal pregnancies, potentially introducing non-independence of observations.
Single-center design
Differential surveillance (increased utilization of fetal and postnatal echocardiography in IVF pregnancies)
Potential selection bias (higher baseline risk of CHD in IVF population)
Lack of direct naturally conceived control group

Implication

While IVF-conceived infants have a higher overall observed prevalence of CHD, the burden is driven by less severe lesions, and the rate of significant CHD requiring intervention approaches general population norms after adjusting for maternal risk factors.

Abstract

Infants conceived via in vitro fertilization (IVF) have been reported to have increased rates of congenital heart disease (CHD), though estimates and associated risk factors remain variable. This study aimed to quantify CHD prevalence by severity sub-type and identify independent predictors of CHD in an IVF-conceived population. A retrospective cohort study of 1890 IVF-conceived infants born to 1783 mothers at a single tertiary academic center from 2020 to 2025 was performed. Maternal demographics, comorbidities, medication exposures, twin gestation, family history, and fetal echocardiography utilization were analyzed. CHD outcomes included: (1) any CHD; (2) persistent CHD (not spontaneously resolved within 3 years); and (3) significant CHD (requiring medical or procedural intervention). Prevalence was compared to the general population baseline (~1%) using Proportion Z testing. Multivariate logistic regression was performed to identify independent predictors. A sensitivity analysis excluded pregnancies with established CHD risk factors to isolate IVF-associated risk. CHD prevalence was 4.76% for any CHD, 3.33% for persistent, and 1.64% for significant. After exclusion of established CHD risk factors, prevalence decreased to 3.1%, 2.1%, and 1.01%, respectively. Fetal echocardiography utilization and diagnostic yield increased with CHD severity. Maternal hypertension, Black race, and Asian race independently predicted any CHD. However, only maternal hypertension predicted persistent CHD and only twin gestation predicted significant CHD. No independent associations were identified for maternal age, geography, median income, other medical conditions (i.e. diabetes, autoimmune), medication exposures, or family history. This IVF-conceived population showed a higher observed prevalence of CHD than global population baseline, though disease burden is driven by less severe heart disease. Distinct predictors varied by CHD severity subtype, supporting risk-stratified fetal echocardiography and individualized counseling in IVF pregnancies.

Discussion

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Cite This Study

Dominy et al. (2026) conducted a cohort in Congenital heart disease (n=1,890). In vitro fertilization (IVF) vs. General population baseline was evaluated on Any structural congenital heart disease (CHD) (p=<0.05). In vitro fertilization was associated with an observed prevalence of any congenital heart disease of 4.76%, which was significantly higher than the 1% general population baseline.

synapsesocial.com/papers/6a70407775942ff7265e57d1 https://doi.org/10.1007/s00246-026-04406-w

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Observed Prevalence and Predictors of Congenital Heart Disease in Infants Conceived via In vitro Fertilization

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Observed Prevalence and Predictors of Congenital Heart Disease in Infants Conceived via In vitro Fertilization

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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