The psychosocial health of children born after medically assisted reproduction : Evidence from the UK Millennium Cohort Study

The increasing number of children conceived through medically assisted reproduction (MAR, including IVF/ICSI, intrauterine insemination and ovulation induction) has led to concerns about the potential negative effects of fertility treatments on children’s psychosocial health. Some studies suggest that MAR children might be at higher risk of developing psychosocial problems when they enter adolescence. However, very few studies have examined the development of MAR children after childhood. Moreover, even though parental socio-economic characteristics are known to be highly correlated with children’s psychosocial development, most existing studies on the outcomes of MAR children did not take into account the selective characteristics of the couples who accessed fertility treatments. Using data from waves 1–6 of the UK Millennium Cohort Study, we compare the psychosocial health, as measured by the Strengths and Difficulties Questionnaire, of MAR children to that of naturally-conceived (NC) children, up to and including the age of 14. We control for a wide range of time-constant child and parental characteristics that might confound the association between MAR and the psychosocial health of children. Results from multilevel random intercept models that do not account for parental characteristics show that MAR children have a lower incidence of psychosocial problems than NC children. In models that control for parental characteristics, MAR children are found to have a higher incidence of psychosocial problems than NC children at age three, which suggests that high parental resource levels both explain the advantage of MAR children in unadjusted models, and mask the potentially adverse effects of MAR at young ages. However, in the fully adjusted models in which MAR children have more psychosocial problems at young age, the differences with respect to NC children decrease with age and become statistically and substantively negligible by end of follow-up at age 14. This result suggests that the use of MAR does not increase children’s risk of having psychosocial problems at the onset of adolescence.Peer reviewe

Health after union dissolution(s): Cumulative and temporal dynamics

The number of individuals experiencing one or multiple union dissolutions in their lifetime is increasing. The literature has shown significant interactions with health disorders, in response to the crisis situation that affects the spouses. However, processes are still unclear, in particular regarding the timing of the affection. This study explored whether different health disorders are observed shortly after dissolution or are delayed, and whether they are short- or long-lasting. We used data from the two waves (2006 and 2010) of the French Health and Professional Lives Survey (SIP) among 8349 individuals aged 25–64 years. Based on three health disorders, we studied 1) their levels in relation to the retrospective histories of union dissolutions; 2) health changes associated with a dissolution occurring between the two waves. We found that individuals who experienced one or multiple union dissolutions had worse self-rated health, more depressive symptoms and sleep disorders. The two latter were more related with a recent dissolution than with distant ones, suggesting an immediate association, yet long-lasting. Self-rated health was related with distant dissolutions only, suggesting a lagged, however also long-lasting association. Experiencing union dissolution between the two waves was linked to a higher probability of the onset of sleep disorders and depressive mood, and of deterioration of self-rated health if it was not the first dissolution. Our study shows that union dissolutions are highly correlated with different poor health measures, in the short and the long run, depending on the health disorder, with cumulative and durable effects

Maternal age and risk of low birth weight and premature birth in children conceived through medically assisted reproduction : Evidence from Finnish population registers

STUDY QUESTION Does the risk of low birth weight and premature birth increase with age among mothers who conceive through medically assisted reproduction (MAR)? SUMMARY ANSWER Among MAR mothers, the risk of poorer birth outcomes does not increase with maternal age at birth except at very advanced maternal ages (40+). WHAT IS KNOWN ALREADY The use of MAR treatments has been increasing over the last few decades and is especially diffused among women who conceive at older ages. Although advanced maternal age is a well-known risk factor for adverse birth outcomes in natural pregnancies, only a few studies have directly analysed the maternal age gradient in birth outcomes for MAR mothers. STUDY DESIGN, SIZE, DURATION The base dataset was a 20% random sample of households with at least one child aged 0-14 at the end of 2000, drawn from the Finnish population register and other administrative registers. This study included children who were born in 1995-2000, because the information on whether a child was conceived through MAR or naturally was available only from 1995 onwards. PARTICIPANTS/MATERIALS, SETTING, METHODS The outcome measures were whether the child had low birth weight (LBW, MAIN RESULTS AND THE ROLE OF CHANCE A total of 56026 children, 2624 of whom were conceived through MAR treatments, were included in the study. Among the mothers who used MAR to conceive, maternal age was not associated with an increased risk of LBW (the overall prevalence was 12.6%) at ages 25-39. For example, compared to the risk of LBW at ages 30-34, the risk was 0.22 percentage points lower (95% CI: -3.2, 2.8) at ages 25-29 and was 1.34 percentage points lower (95% CI: -4.5, 1.0) at ages 35-39. The risk of LBW was increased only at maternal ages >= 40 (six percentage points, 95% CI: 0.2, 12). Adjustment for maternal characteristics only marginally attenuated these associations. In contrast, among the mothers who conceived naturally, the results showed a clear age gradient. For example, compared to the risk of LBW (the overall prevalence was 3.3%) at maternal ages 30-34, the risk was 1.1 percentage points higher (95% CI: 0.6, 1.6) at ages 35-39 and was 1.5 percentage points higher (95% CI: 0.5, 2.6) at ages >= 40. The results were similar for preterm births. LIMITATIONS, REASON FOR CAUTION A limited number of confounders were included in the study because of the administrative nature of the data used. Our ability to reliably distinguish mothers based on MAR treatment type was also limited. WIDER IMPLICATIONS OF THE FINDINGS This is the first study to analyse the maternal age gradient in the risk of adverse birth outcomes among children conceived through MAR using data from a nationally representative sample and controlling for important maternal health and socio-economic characteristics. This topic is of considerable importance in light of the widespread and increasing use of MAR treatments.Peer reviewe

Il trattamento del gozzo immerso. La nostra esperienza

Gli Autori, dopo avere accennato alla storia naturale del gozzo immerso, riferiscono la loro esperienza di tale patologia maturata negli ultimi 5 anni, sottolineando i caratteri della complessa sintoma - tologia osservata nei vari casi, la condotta terapeutica seguìta, i buoni risultati ottenuti. Si soffermano quindi ad elencare le molteplici classificazioni, via via proposte. Illustrano le complesse situazioni sia di ordine emodina - mico che respiratorio di particolare interesse anestesiologico. Discutono, infine, sulla diagnostica e soprattutto sul corretto atteggiamento terapeutico il cui obiettivo è duplice: risolvere la sinto - matologia prodotta dalla massa mediastinica ed escludere la possibi - lità di recidiv

Outcomes of fertility treatments for children and families

A continued postponement of childbearing and the rapid technological development that have occurred in the last decades have led to a considerable increase in the demand and use of fertility treatments and Assisted Reproductive Technologies (ART). Since the first birth in vitro in 1978 an estimated 5 million babies have been born through ART worldwide, with the number of couples seeking fertility treatments continuously increasing (Calhaz-Jorge et al., 2016). In light of the great expansion in the use of ART and fertility treatments and of the intense debates about their regulation, funding and use, there is a growing urgency to understand the long-term outcomes of such treatments. This thesis studies the outcomes of fertility treatments for children and families and specifically childrenâs cognitive development, parenting and couplesâ stability. While there is evidence of increased health risks for children at birth such as multiple births and low birth weight, the literature has usually shown a good development of children and positive family functioning. However, the existing literature presents several limitations especially on the long-term outcomes. Furthermore, the demographic and socio-economic characteristics of couples accessing the treatments have been neglected. This is a crucial point, as people accessing the treatments tend to be older and from an advantaged socio-economic background, which is likely to affect the observed outcomes. I rely on representative, longitudinal data from the UK Millennium Cohort Study (MCS) and the US National Survey of Family Growth (NSFG), which allow me to follow a consistent number of children and families to study their outcomes over time. An important focus is on how the observed outcomes might be affected by the selective background of individuals who can afford the expensive treatments in the UK and US.</p

Outcomes of fertility treatments for children and families

A continued postponement of childbearing and the rapid technological development that have occurred in the last decades have led to a considerable increase in the demand and use of fertility treatments and Assisted Reproductive Technologies (ART). Since the first birth in vitro in 1978 an estimated 5 million babies have been born through ART worldwide, with the number of couples seeking fertility treatments continuously increasing (Calhaz-Jorge et al., 2016). In light of the great expansion in the use of ART and fertility treatments and of the intense debates about their regulation, funding and use, there is a growing urgency to understand the long-term outcomes of such treatments. This thesis studies the outcomes of fertility treatments for children and families and specifically children’s cognitive development, parenting and couples’ stability. While there is evidence of increased health risks for children at birth such as multiple births and low birth weight, the literature has usually shown a good development of children and positive family functioning. However, the existing literature presents several limitations especially on the long-term outcomes. Furthermore, the demographic and socio-economic characteristics of couples accessing the treatments have been neglected. This is a crucial point, as people accessing the treatments tend to be older and from an advantaged socio-economic background, which is likely to affect the observed outcomes. I rely on representative, longitudinal data from the UK Millennium Cohort Study (MCS) and the US National Survey of Family Growth (NSFG), which allow me to follow a consistent number of children and families to study their outcomes over time. An important focus is on how the observed outcomes might be affected by the selective background of individuals who can afford the expensive treatments in the UK and US.</p

Couple instability and uncertainty. Family transitions during the COVID-19 pandemic

International audienc

Women’s Employment–Family Trajectories and Well-Being in Later Life: Evidence From France

Objective: Previous research in various countries has found that employment-family trajectories characterized by early or single motherhood, or weak ties to employment, are associated with poor well-being among older women. Our paper explores whether this differs (1) in France, characterized by a high female employment rate and supportive family policies; (2) across dimensions of well-being. Method: We used the Health and Occupational Itinerary survey to identify 10 common patterns of employment?family trajectories (derived from multi-channel sequence analysis) and analysed their association with six indicators of well-being in 2010 (N = 2882 50?78 years old women). Results: Continuous full-time employment is associated with better well-being, except for women who had a first child around 24 years old, who reported increased anxiety and lack of support. Discussion: Employed mothers' well-being seems to be protected in a context of family friendly policies, but we identified one group with lower well-being, which merits further study

Gendered employment-family trajectories and multidimensional wellbeing. Evidence from France

This paper adopts a holistic and multidimensional life course perspective to study how employment and family trajectories are combined and affect wellbeing. We draw on data from the French Health and Professional Itinerary survey (2006-2010), to identify long-term patterns of employment-family trajectories and test their association with physical and mental health, social support and satisfaction with professional life. Our findings unveil types of employment-family trajectories that interfere with distinct dimensions of wellbeing for men and women. For both men and women, employment family trajectories including early transitions toward partnership and parenthood are related to reduced levels of most wellbeing outcomes. For women, trajectories including substantial career interruptions are associated with lower levels of wellbeing. For men only, trajectories that include single parenthood, or childlessness, imply decreased wellbeing outcomes. The associations are unequal between the different wellbeing indicators, attesting their complementary and the relevance of considering multiple dimensions of wellbeing