Fertility problems and their relationship to child mental health

A recently published study that has reported a link between fertility problems and children’s mental health issues has attracted significant media attention. The story has been covered by the Guardian, the Telegraph, the Independent, the Scotsman, the Times, and countless health websites e.g. Nursing Times. Reporting of the study ranged from excellent such as the Guardian coverage to what could be considered not so good! So what’s this study all about?

Who are the researchers and what did they do?

First I should note that the study has not been peer reviewed and published in an academic journal yet, but instead represents findings presented at an academic conference. The Guardian did well to highlight this. As we have pointed out in a recent post in our How to “Research the Headlines” series, readers should be aware that conference presentations will not have been subjected to any intensive peer review process. This does not directly question the integrity of the findings as many academics present their findings prior to securing publication but the reader should be aware that the study hasn’t necessarily been subject to significant review by expert academic peers.

The research team led by Dr. Allan Jensen, at the University of Copenhagen, examined patient records of more than 2.4 million children born in Denmark between 1969 and 2006. 5% were born to mothers with registered fertility problems (which could have represented issues with either parent) while 95% of mothers were recorded as having no such problems.

The researchers followed the children’s medical histories, typically for 20 years, until 2009. During that time, children born to parents with fertility problems had a 33% higher risk of psychiatric disorders. The children had a 40% higher risk of attention deficit hyperactivity disorder (ADHD), a 27% higher risk of schizophrenia and psychoses, a 37% higher risk of anxiety and neurotic disorders, an 28% greater risk of learning difficulties, and a 22% higher risk of mental development disorders, including autism spectrum disorders.

So how did the media handle the findings?

Several media outlets made inappropriate causal links which we will soon be posting about in our How to “Research the Headlines” series. The Toronto Sun actually ran with the headline: “Trouble conceiving could lead to mental illness in children: Study” – while the ‘could’ somewhat moderates the link, the ‘lead’ misrepresents the findings. These types of headlines could lead the reader to infer that the assisted conception process leads to mental illness in children. Most media outlets though were careful to point out that genetics are likely to account for the findings.

A few of the media outlets inappropriately suggest that the mothers without fertility problems were ‘healthier’. Quite worryingly the opening line of the Toronto Sun article was “Women who battle fertility problems are more likely to give birth to children who develop psychiatric disorders than those born to healthier mothers, research suggests”. There is no suggestion from this study that women who have fertility problems are less ‘healthy’ so this is misleading and sensationalist.

The Guardian also compared parents with fertility problems to ‘healthier’ mothers and fathers but incorporated a number of important features in their article to ensure the findings were represented accurately. The journalist emphasised the researchers concern that “genetic faults or other biological problems with the mother or father were more likely to blame than any fertility treatment they had”, and importantly included a number of aspects we have emphasised in our ‘How to’ series including use of quotes from both the study authors and other independent experts. The journalist also noted that the study reflected a conference presentation rather than a peer reviewed published study. Importantly, they also amended their article after publication to be more accurate. At the end of the article it states that “this article was amended on 30 June 2014 to clarify that the fertility problems could have originated with either parent, not just the mother”. We don’t know whether this arose because the study authors provided this clarification or not, but regardless the journalist has shown their commitment to conveying accurate study reporting by including this.

The bottom line

The study shows a link between having fertility problems and child mental health but this is an association rather than a causal link and is likely to reflect genetic or other biological problems with the parents rather than relating to the assisted conception process.