Department of Ophthalmology, University Hospital, Lund, Sweden.
Am J Ophthalmol. 2010 Jul;150(1):23-6. doi: 10.1016/j.ajo.2010.01.035. Epub 2010 May 5.
To follow up children born after in vitro fertilization (IVF) with respect to eye malformations and poor visual acuity.
Observational cohort study based on Swedish health registers.
Congenital eye malformations were studied in 32 091 children born from 1982 through 2007 and severe visual impairment was studied in 24 628 children born from 1985 through 2005 after IVF in Sweden. Comparisons were made with all children born in Sweden during corresponding periods with adjustment for various confounders. The main outcome measure was the presence of a congenital eye malformation and poor visual acuity.
Thirty-six (1.1 per 1000) IVF infants with ocular malformations were identified, and the risk, compared with non-IVF children, was not increased when adjusted for maternal age, parity, smoking, and body mass index (odds ratio, 1.05; 95% confidence interval, 0.75 to 1.47). Severe visual impairment was identified in 25 cases (1.0 per 1000), and the risk increase was statistically significant (odds ratio, 1.65; 95% confidence interval, 1.12 to 2.45) and was only slightly reduced when adjustment as above was made (odds ratio, 1.55; 95% confidence interval, 1.04 to 2.32). When adjustment was made for known length of unwanted childlessness, the OR decreased to 1.15 (95% confidence interval, 0.61 to 2.16). Only 3 of the 25 children with visual impairment had ocular malformations.
Although there is an increased risk for visual impairment among children born after IVF, the individual risk is small and may be secondary to parental characteristics. No increased risk for eye malformations was found.
对体外受精(IVF)后出生的儿童进行眼部畸形和视力不良的随访。
基于瑞典健康登记的观察性队列研究。
在瑞典,1982 年至 2007 年间出生的 32091 名儿童中,研究了先天性眼部畸形;1985 年至 2005 年间出生的 24628 名 IVF 后严重视力障碍的儿童。通过与同期在瑞典出生的所有儿童进行比较,调整了各种混杂因素。主要观察指标为先天性眼部畸形和视力不良的存在。
发现 36 例(1.1/1000)IVF 婴儿有眼部畸形,与非 IVF 儿童相比,调整母亲年龄、产次、吸烟和体重指数后,风险并未增加(比值比,1.05;95%置信区间,0.75 至 1.47)。发现 25 例(1.0/1000)严重视力障碍,风险增加具有统计学意义(比值比,1.65;95%置信区间,1.12 至 2.45),当进行上述调整时,风险略有降低(比值比,1.55;95%置信区间,1.04 至 2.32)。当对已知的非意愿性不孕时间进行调整时,OR 降至 1.15(95%置信区间,0.61 至 2.16)。仅 25 名视力障碍儿童中有 3 名存在眼部畸形。
虽然 IVF 后出生的儿童视力障碍风险增加,但个体风险较小,可能与父母特征有关。未发现眼部畸形风险增加。