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To elucidate the associations among assisted reproduction (in vitro fertilization with or without intracytoplasmic sperm injection), twinning, and major congenital heart defects, investigators analyzed a cohort of all births in Ontario, Canada, from 2012 to 2015, including 497,241 naturally occurring pregnancies (98%) and 10,149 pregnancies achieved with assisted reproduction (2%).
Congenital heart defects occurred in 1.2% of natural pregnancies and 2.2% of assisted reproduction pregnancies. Twinning occurred in 1.4% of natural pregnancies and 18.5% of assisted reproduction pregnancies. A strong association between twin pregnancy and major congenital heart defects was seen for both the natural (adjusted odds ratio, 4.9) and assisted reproduc…