# The Role of Perinatal Complications in Neurodevelopmental Outcomes of ART-Conceived Children: Prognostic Model for Brain Immaturity

## TL;DR

This study examines the neurodevelopmental outcomes of children conceived via ART in Kazakhstan and finds that perinatal complications, not ART itself, are key predictors of brain immaturity.

## Contribution

A novel prognostic model is developed to identify risk factors for neurodevelopmental issues in ART-conceived children.

## Key findings

- ART-conceived children showed higher signs of brain immaturity in neurosonographic assessments.
- Perinatal complications like prematurity and low birth weight were significant predictors of neurodevelopmental issues.
- ART itself was not an independent risk factor for neurological problems.

## Abstract

Background/Objectives: Since the first successful birth following assisted reproductive technologies (ART) several decades ago, the global population of ART-conceived children has surpassed 13 million, with over 40,000 born in Kazakhstan. Despite this growth, questions remain about their long-term neurological outcomes, with existing studies reporting inconsistent findings. This study aimed to assess psychomotor development and the prevalence of nervous system pathologies among ART-conceived children in Kazakhstan and to develop a prognostic model for identifying pathological neurodevelopmental conditions. Methods: We studied 252 children (120 conceived via ART and 132 controls) using clinical examination and medical history data. Brain immaturity predictors were identified by univariate and multivariate logistic regression. Results: ART-conceived children exhibited a higher incidence of neurosonographic signs of brain structure immaturity. However, multivariate analysis indicated that ART itself was not an independent risk factor. Instead, perinatal complications—including prematurity, multiple pregnancy, low birth weight, asphyxia, and intrauterine infections—explained the observed differences. The prognostic model highlighted prematurity and preconceptional progesterone therapy as significant predictors. Overall neurological development did not differ significantly between the groups. Conclusions: These findings underscore the importance of early identification of perinatal risk factors and targeted preventive interventions to mitigate adverse neurodevelopmental outcomes in ART-conceived children.