Dataset Information

Medically assisted reproduction and parent-child relationships during adolescence: evidence from the UK Millennium Cohort Study.

ABSTRACT:

Study question

Do the parent-child relationships of adolescents born after medically assisted reproduction (MAR) using the parents' own gametes differ from those of adolescents born after natural conception (NC)?

Summary answer

MAR and NC families have similar parent-child relationships in terms of closeness and conflict frequency, except that MAR mothers report being closer to their children than NC mothers.

What is known already

Prior work on parent-child relationships during childhood has reported mixed findings. While some studies have documented no differences between MAR and NC families, others have shown that MAR families have greater levels of warmth and positive feelings than NC families. Evidence on parent-child relationships during the adolescent period is generally positive but is limited because of the small number of existing studies and the reliance on small samples.

Study design, size, duration

This work is based on the UK Millennium Cohort Study, whose study members were born in 2000-2002. The analyses focused on Sweep 6 which was collected when cohort members were around 14?years old. We also relied on variables collected in Sweep 1, when cohort members were aged around 9?months, to account for characteristics that could confound or mediate the relationship between MAR and our outcomes. The attrition rate between Sweeps 1 and 6 was 36.7%.

Participants/materials, setting, methods

The final sample consisted of 10 233 cohort members, 320 of whom were conceived with the help of MAR (3.1%). A total of six dependent variables were used to measure, when the cohort members were around 14?years old, levels of parent-child closeness and conflict, reported separately by the mother, the father and the cohort member. Linear models were used to analyse the association between parent-child relationships before and after adjustment for socio-demographic characteristics and mental health.

Main results and the role of chance

Sweep 6 achieved a response rate of 76.3% of the eligible sample. The results show that, on average, MAR and NC families had similar parent-child relationships in terms of closeness and conflict frequency. The only difference was that MAR mothers reported being closer to their children than NC mothers both before (??=?0.149, P?Limitations, reasons for cautionThe outcome variables are self-reported by each of the respondents and could be subject to social desirability bias. Second, some parents may have not reported they conceived through donor insemination, which could result in the analytical sample including a small subset of children who were not genetically related to their parents. Third, the data did not include information about whether the children were aware of their conception mode, since the Millennium Cohort Study did not collect information on MAR disclosure. Moreover, they did not allow us to study other aspects of parent-child relationships. Finally, as we observed parent-child relationships at only one moment in time; we were unable to test whether they changed over time.

Wider implications of the findings

The results suggest that the difficulties and the stress parents underwent to conceive through MAR did not translate into more difficult parent-child relationships during adolescence. Given the increasing number of children conceived via MAR, the finding that MAR and NC families had similar parent-child relationships in terms of closeness and conflict frequency is reassuring.

Study funding/competing interest(s)

This work was supported by European Research Council agreement n. 803959 (MARTE to A.G.). The authors declare no competing interests.

Trial registration number

n/a.

SUBMITTER: Goisis A

PROVIDER: S-EPMC7891809 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

Medically assisted reproduction and parent-child relationships during adolescence: evidence from the UK Millennium Cohort Study.

Goisis Alice A Palma Maria M

Human reproduction (Oxford, England) 20210201 3

<h4>Study question</h4>Do the parent-child relationships of adolescents born after medically assisted reproduction (MAR) using the parents' own gametes differ from those of adolescents born after natural conception (NC)?<h4>Summary answer</h4>MAR and NC families have similar parent-child relationships in terms of closeness and conflict frequency, except that MAR mothers report being closer to their children than NC mothers.<h4>What is known already</h4>Prior work on parent-child relationships du ...[more]

PMID: 33394012

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Project description:BackgroundPrevious research has documented that children conceived through medically assisted reproduction (MAR) are at increased risk of poor birth outcomes, such as low birthweight (LBW), which are risk factors for stunted longer-term cognitive development. However, parents who undergo MAR to conceive have, on average, advantaged socioeconomic backgrounds which could compensate for the negative effects of being born LBW. Previous studies have not analysed whether the negative effects of LBW are attenuated among MAR conceived children.MethodsWe draw on the UK Millennium Cohort Study (sweeps 1-6) which contains a sub-sample of (N = 396) MAR-conceived children. The dependent variable measures cognitive ability at around ages 3, 5, 7, 11 and 14. We examine the cognitive development of four groups of children: MAR-conceived low birthweight (MAR LBW); MAR-conceived non-low birthweight (MAR NLBW); naturally conceived low birthweight (NC LBW); naturally conceived non-low birthweight (NC NLBW). We estimate the two following linear regression models for each sweep: (i) a baseline model to examine the unadjusted association between cognitive development and low birthweight by mode of conception; and (ii) a model adjusted by socio-demographic family characteristics.ResultsIn baseline models, MAR LBW children [age 3: β = 0.021, 95% confidence interval (CI): -0.198, 0.241; age 5: β = 0.21, 95% CI: 0.009, 0.418; age 7: β = 0.163, 95% CI: -0.148, 0.474; age 11: β = 0.003, 95% CI: -0.318, 0.325; age 14: β = 0.156, 95% CI: -0.205, 0.517], on average perform similarly in cognitive ability relative to NC NLBW at all ages, and display higher cognitive scores than NC LBW children until age 7. When we account for family characteristics, differences are largely attenuated and become close to zero at age 14.ConclusionsDespite the higher incidence of LBW among MAR compared with NC children, they do not seem to experience any disadvantage in their cognitive development compared with naturally conceived children. This finding is likely explained by the fact that, on average, MAR children are born to socioeconomically advantaged parents.

Project description:This study aimed to identify determinants of a late autism spectrum disorder diagnosis, including diagnoses made 'very late' (i.e., in adolescence), using the Millennium Cohort Study, a nationally representative population-based cohort in the United Kingdom. Children diagnosed with autism spectrum disorder by age 14 (N = 581) were included and grouped by the parent-reported timing of diagnosis: before school (up to age 5), during primary school (age 5-11) and during secondary school (age 11-14). Predictors of diagnostic timing, at the child, family and school levels, were investigated using multinomial logistic regression. Most (79%) children with autism spectrum disorder were diagnosed after school entry, and 28% were not diagnosed until secondary school. Among those not diagnosed until secondary school, 75% had been identified at age 5 years by a parent and/or teacher as having socio-behavioural difficulties. Being diagnosed after starting school was predicted by living in poverty (adjusted relative risk ratio: primary = 1.90, 95% confidence interval: 1.03-3.53; secondary = 2.15, 1.05-4.42) and/or having no initial parental concerns (primary = 0.32, 0.15-0.70; secondary = 0.19, 0.09-0.43). Having typical-range intelligence also predicted diagnosis during secondary school. The result indicates that those without cognitive delays and poorer children were at risk of 'very late' (i.e. adolescent) diagnosis. Strategies to promote earlier identification, targeting age at primary school entry, could help those more likely to be diagnosed late.Lay abstractDespite policy emphasis on early identification, many children with autism spectrum disorder are diagnosed late, with some being diagnosed as late as in adolescence. However, evidence on what determines the timing of autism spectrum disorder diagnosis including children diagnosed in adolescence is lacking. Understanding these determinants, particularly in those diagnosed later than is ideal, can inform the development of effective strategies to improve earlier identification of autism spectrum disorder. This study used a nationally representative population-based cohort in the United Kingdom to explore child, family and school level predictors of timing of autism spectrum disorder diagnosis. In the United Kingdom, 79% of the children with autism spectrum disorder were diagnosed after entering primary school and 28% during secondary school. Among those not diagnosed until secondary school, 75% had shown social difficulties noticed by parents and/or teachers at age 5 years. The results suggest that healthcare providers should be aware that, even for universal systems of care, those living in poverty and having higher intelligence are most likely to miss out on a timely diagnosis. Strategies to promote earlier identification among school-aged children, including targeting primary school entry age (i.e. around age 5) and that encouraging referrals for a formal assessment at the first report of concerns over the child's social development may benefit those children who would otherwise be diagnosed later.

Dataset Information

Medically assisted reproduction and parent-child relationships during adolescence: evidence from the UK Millennium Cohort Study.

Study question

Summary answer

What is known already

Study design, size, duration

Participants/materials, setting, methods

Main results and the role of chance

Wider implications of the findings

Study funding/competing interest(s)

Trial registration number

Publications

Medically assisted reproduction and parent-child relationships during adolescence: evidence from the UK Millennium Cohort Study.

Similar Datasets

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