{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T04:45:33Z","timestamp":1780980333483,"version":"3.54.1"},"reference-count":42,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,3,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVES:<\/jats:title>\n                  <jats:p>We examined the prevalence of Early Intervention (EI) enrollment in Massachusetts comparing singleton children conceived via assisted reproductive technology (ART), children born to mothers with indicators of subfertility but no ART (Subfertile), and children born to mothers who had no indicators of subfertility and conceived naturally (Fertile). We assessed the natural direct effect (NDE), the natural indirect effect (NIE) through preterm birth, and the total effect of ART and subfertility on EI enrollment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>We examined maternal and infant characteristics among singleton ART (n = 6447), Subfertile (n = 5515), and Fertile (n = 306\u2009343) groups and characteristics associated with EI enrollment includingpreterm birth using \u03c72 statistics (\u03b1 = 0.05). We estimated the NDE and NIE of the ART\u2013EI enrollment relationship by fitting a model for enrollment, conditional on ART, preterm and the ART-preterm delivery interaction, and covariates. Similar analyses were conducted by using Subfertile as the exposure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>The NDE indicated that the odds of EI enrollment were 27% higher among the ART group (odds ratioNDE = 1.27; 95% confidence interval (CI): 1.19 \u0336 1.36) and 20% higher among the Subfertilegroup (odds ratioNDE = 1.20; 95% CI: 1.12 \u0336 1.29) compared with the Fertile group, even if the rate of preterm birth is held constant.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>Singleton children conceived through ART and children of subfertile mothers both have elevated risks of EI enrollment. These findings have implications for clinical providers as they counsel women about child health outcomes associated with ART or subfertility.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2015-2007","type":"journal-article","created":{"date-parts":[[2016,2,5]],"date-time":"2016-02-05T03:23:19Z","timestamp":1454642599000},"source":"Crossref","is-referenced-by-count":13,"title":["Assisted Reproductive Technology and Early Intervention Program Enrollment"],"prefix":"10.1542","volume":"137","author":[{"given":"Hafsatou","family":"Diop","sequence":"first","affiliation":[{"name":"Massachusetts Department of Public Health, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daksha","family":"Gopal","sequence":"additional","affiliation":[{"name":"Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard","family":"Cabral","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candice","family":"Belanoff","sequence":"additional","affiliation":[{"name":"Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene R.","family":"Declercq","sequence":"additional","affiliation":[{"name":"Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milton","family":"Kotelchuck","sequence":"additional","affiliation":[{"name":"Center for Child and Adolescent Health Research and Policy, Massachusetts General Hospital for Children and Harvard Medical School, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Luke","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Biology, Michigan State University, East Lansing, Michigan; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judy E.","family":"Stern","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology and Pathology, Geisel School of Medicine, Dartmouth College, Lebanon, New Hampshire"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2016,3,1]]},"reference":[{"issue":"10","key":"2021121117165460200_B1","first-page":"1","article-title":"Assisted reproductive technology surveillance\u2014United States, 2011.","volume":"63","author":"Sunderam","year":"2014","journal-title":"MMWR Surveill Summ"},{"issue":"10","key":"2021121117165460200_B2","doi-asserted-by":"crossref","first-page":"2099","DOI":"10.1093\/humrep\/deu175","article-title":"Assisted reproductive technology in Europe, 2010: results generated from European registers by ESHRE.","volume":"29","author":"Kupka","year":"2014","journal-title":"Hum Reprod"},{"issue":"1","key":"2021121117165460200_B3","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.fertnstert.2007.01.167","article-title":"Insurance mandates and trends in infertility treatments.","volume":"89","author":"Henne","year":"2008","journal-title":"Fertil Steril"},{"issue":"8","key":"2021121117165460200_B4","doi-asserted-by":"crossref","first-page":"1941","DOI":"10.1093\/humrep\/den169","article-title":"Perinatal outcomes of twin births conceived using assisted reproduction technology: a population-based study.","volume":"23","author":"Boulet","year":"2008","journal-title":"Hum Reprod"},{"issue":"4","key":"2021121117165460200_B5","first-page":"1","article-title":"Assisted reproductive technology surveillance\u2014United States, 2003.","volume":"55","author":"Wright","year":"2006","journal-title":"MMWR Surveill Summ"},{"issue":"2","key":"2021121117165460200_B6","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.fertnstert.2012.12.032","article-title":"Assisted reproductive technologies and perinatal morbidity: interrogating the association.","volume":"99","author":"Barnhart","year":"2013","journal-title":"Fertil Steril"},{"issue":"4","key":"2021121117165460200_B7","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1093\/humrep\/des448","article-title":"Increased risk of preterm birth in singleton pregnancies after blastocyst versus day 3 embryo transfer: Canadian ART Register (CARTR) analysis.","volume":"28","author":"Dar","year":"2013","journal-title":"Hum Reprod"},{"issue":"3","key":"2021121117165460200_B8","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1053\/siny.2002.0109","article-title":"Neurological outcome in twins.","volume":"7","author":"Pharoah","year":"2002","journal-title":"Semin Neonatol"},{"issue":"6","key":"2021121117165460200_B9","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1097\/01.AOG.0000127037.12652.76","article-title":"Perinatal outcome among singleton infants conceived through assisted reproductive technology in the United States.","volume":"103","author":"Schieve","year":"2004","journal-title":"Obstet Gynecol"},{"issue":"4","key":"2021121117165460200_B10","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.siny.2014.03.002","article-title":"The impact of assisted reproductive technologies on intra-uterine growth and birth defects in singletons.","volume":"19","author":"Hansen","year":"2014","journal-title":"Semin Fetal Neonatal Med"},{"issue":"2","key":"2021121117165460200_B11","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1093\/humupd\/dms044","article-title":"Why do singletons conceived after assisted reproduction technology have adverse perinatal outcome? 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