Does Developmental Performance Differ for Children Conceived by IVF?

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1. You are a member of the healthcare team advising a 33-year-old woman regarding likely long-term outcomes of in vitro fertilization (IVF). According to the causal inference approach used in the population-wide cohort study by Kennedy and colleagues, which of the following statements about the causal effect of IVF conception on primary school-age childhood developmental and educational outcomes compared with outcomes after spontaneous conception is correct?
   Parents of IVF-conceived vs spontaneously conceived children had similar demographics, parity, and educational and socioeconomic status
   IVF conception was linked to significantly greater risk for developmental vulnerability at school-entry (Australian Early Developmental Census [AEDC])
   At age 7 to 9 years, IVF had no causal effect on overall National Assessment Program-Literacy and Numeracy (NAPLAN) for IVF-conceived vs spontaneously conceived children (adjusted mean difference 0.03 [95% CI: −0.018, 0.077])
   In 4 of 5 NAPLAN domains, IVF-conceived children were more likely to be below the national minimum standard than spontaneously conceived children
2. According to the causal inference approach used in the population-wide cohort study by Kennedy and colleagues, which of the following statements about clinical and public health implications of the causal effect of IVF conception on primary school-age childhood developmental and educational outcomes compared with outcomes after spontaneous conception is correct?
   School-age developmental and educational outcomes for children conceived by IVF are slightly inferior to those of spontaneously conceived children
   The findings offer important reassurance for current/prospective parents and clinicians and may help provide informed consent and education
   Lower IVF risks in this study than in previous studies likely result from smaller sample size
   The study proves that IVF has no risks for offspring