Inserm UMR 1153, Equipe de recherche en Epidémiologie Obstétricale, Périnatale et Pédiatrique (EPOPé), Centre de Recherche Epidémiologie et Statistique Sorbonne Paris Cité DHU Risques et grossesse, Université Paris Descartes, Paris, France.
Centre Pluridisciplinaire de Diagnostic Prénatal de l'Est Parisien, Pôle de périnatalité, Hôpital Trousseau, Paris, France.
BJOG. 2015 Jun;122(7):924-31. doi: 10.1111/1471-0528.13345. Epub 2015 Mar 6.
To compare the probability of prenatal diagnosis (PND) and termination of pregnancy for fetal anomaly (TOPFA) between fetuses conceived by assisted reproductive techniques (ART) and spontaneously-conceived fetuses with congenital heart defects (CHD).
Population-based observational study.
Paris and surrounding suburbs.
Fetuses with CHD in the Paris registry of congenital malformations and cohort of children with CHD (Epicard).
Comparison of ART-conceived and spontaneously conceived fetuses taking into account potential confounders (maternal characteristics, multiplicity and year of birth or TOPFA).
Probability and gestational age at PND and TOPFA for ART-conceived versus spontaneously conceived fetuses.
The probability of PND (28.1% versus 34.6%, P = 0.077) and TOPFA (36.2% versus 39.2%, P = 0.677) were not statistically different between ART-conceived (n = 171) and spontaneously conceived (n = 4620) fetuses. Estimates were similar after adjustment for potential confounders. Gestational age at PND tended to be earlier for ART fetuses (23.1 versus 24.8 weeks, P = 0.05) but no statistical difference was found after adjustment for confounders. Gestational age at TOPFA was comparable between ART-conceived and spontaneously conceived fetuses.
In our population, ART conception was not significantly associated with the probability of PND or TOPFA for CHD. One implication of our results is that live births may be adequate for assessing the overall risk of CHD related to ART. However, total prevalence, in particular of severe CHD, would not be adequately assessed if TOPFA are not included.
比较辅助生殖技术（ART）受孕胎儿和先天性心脏病（CHD）自发受孕胎儿的产前诊断（PND）和终止妊娠胎儿异常（TOPFA）的概率。
基于人群的观察性研究。
巴黎及其周边地区。
巴黎出生缺陷登记处和 CHD 患儿队列（Epicard）中患有 CHD 的胎儿。
考虑到潜在混杂因素（母体特征、多胎妊娠和出生年份或 TOPFA），比较 ART 受孕和自发受孕的胎儿。
ART 受孕与自发受孕胎儿 PND 和 TOPFA 的概率和孕龄。
ART 受孕（n = 171）和自发受孕（n = 4620）胎儿的 PND 概率（28.1%比 34.6%，P = 0.077）和 TOPFA 概率（36.2%比 39.2%，P = 0.677）无统计学差异。调整潜在混杂因素后，估计值相似。PND 的孕龄趋于较早，ART 胎儿为 23.1 周，自发受孕胎儿为 24.8 周，（P = 0.05），但调整混杂因素后无统计学差异。TOPFA 的孕龄在 ART 受孕和自发受孕胎儿之间相当。
在我们的人群中，ART 受孕与 CHD 的 PND 或 TOPFA 概率无显著相关性。我们研究结果的一个含义是，活产儿可能足以评估与 ART 相关的 CHD 的总体风险。然而，如果不包括 TOPFA，则无法充分评估总患病率，特别是严重 CHD 的患病率。
