{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T20:34:36Z","timestamp":1793133276138,"version":"4.5.0"},"reference-count":29,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Cardiol"],"published-print":{"date-parts":[[2023,9,1]]},"abstract":"Importance<\/jats:title>The use of assisted reproductive technologies (ARTs) is steadily increasing worldwide. The outcomes associated with treatment for an individual\u2019s long-term health, including risk of cardiovascular disease (CVD), remain largely unknown, due to the small number of studies and their limited follow-up time.<\/jats:p><\/jats:sec>Objective<\/jats:title>To study whether the risk of CVD is increased among individuals who have given birth after ART compared with those who have given birth without ART.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>A registry-based cohort study was conducted using nationwide data from Denmark (1994-2014), Finland (1990-2014), Norway (1984-2015), and Sweden (1985-2015). Data analysis was conducted from January to August 2022. A total of 2\u202f496\u202f441 individuals with a registered delivery in the national birth registries during the study period were included, and 97\u202f474 (4%) of these gave birth after ART.<\/jats:p><\/jats:sec>Exposures<\/jats:title>Data on ART conception were available from ART quality registries and\/or medical birth registries.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Information on CVD was available from patient and cause of death registries. The risk of CVD was estimated with Cox proportional hazards regression, adjusting for age, calendar year of start of follow-up, parity, diagnosis of polycystic ovary syndrome, diabetes, chronic hypertension, and country.<\/jats:p><\/jats:sec>Results<\/jats:title>Median follow-up was 11 (IQR, 5-18) years. The mean (SD) age of women with no use of ART was 29.1 (4.9) years, and the age of those who used ART was 33.8 (4.7) years. The rate of any CVD was 153 per 100\u202f000 person-years. Individuals who gave birth after using ART had no increased risk of CVD (adjusted hazard ratio [AHR], 0.97; 95% CI, 0.91-1.02), with evidence of heterogeneity between the countries (I<\/jats:italic>2<\/jats:sup>\u2009=\u200976%; P<\/jats:italic>\u2009=\u2009.01 for heterogeneity). No significant differences in the risk of ischemic heart disease, cerebrovascular disease, stroke, cardiomyopathy, heart failure, pulmonary embolism, or deep vein thrombosis were noted with use of ART. However, there was a tendency for a modest reduction in the risk of myocardial infarction (AHR, 0.80; 95% CI, 0.65-0.99), with no notable heterogeneity between countries.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>The findings of this study suggest that women who gave birth after ART were not at increased risk of CVD over a median follow-up of 11 years compared with those who conceived without ART. Longer-term studies are needed to further examine whether ART is associated with higher risk of CVD.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamacardio.2023.2324","type":"journal-article","created":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T15:02:21Z","timestamp":1691593341000},"page":"837","source":"Crossref","is-referenced-by-count":45,"title":["Maternal Risk of Cardiovascular Disease After Use of Assisted Reproductive Technologies"],"prefix":"10.1001","volume":"8","author":[{"given":"Maria C.","family":"Magnus","sequence":"first","affiliation":[{"name":"Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail","family":"Fraser","sequence":"additional","affiliation":[{"name":"Population Health Sciences, Bristol Medical School, Bristol, United Kingdom"},{"name":"MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siri E.","family":"H\u00e5berg","sequence":"additional","affiliation":[{"name":"Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristiina","family":"R\u00f6n\u00f6","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liv Bente","family":"Romundstad","sequence":"additional","affiliation":[{"name":"Spiren Fertility Clinic, Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Bergh","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg and Region V\u00e4stra G\u00f6taland, Sahlgrenska University Hospital, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne L\u00e6rke","family":"Spangmose","sequence":"additional","affiliation":[{"name":"Fertility Department, Copenhagen University Hospital, Rigshospitalet, Denmark, Copenhagen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"Pinborg","sequence":"additional","affiliation":[{"name":"Fertility Department, Copenhagen University Hospital, Rigshospitalet, Denmark, Copenhagen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mika","family":"Gissler","sequence":"additional","affiliation":[{"name":"Finnish Institute for Health and Welfare, Helsinki, Finland, Region Stockholm, Academic Primary Health Care Centre, Stockholm, Sweden"},{"name":"Karolinska Institutet, Department of Molecular Medicine and Surgery, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulla-Britt","family":"Wennerholm","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg and Region V\u00e4stra G\u00f6taland, Sahlgrenska University Hospital, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f8rn Olav","family":"\u00c5svold","sequence":"additional","affiliation":[{"name":"K. 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