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接受辅助生殖技术的母亲所生婴儿的先天性畸形:一项系统评价和荟萃分析研究

Congenital Malformations in Infants of Mothers Undergoing Assisted Reproductive Technologies: A Systematic Review and Meta-analysis Study.

作者信息

Hoorsan Hayedeh, Mirmiran Parvin, Chaichian Shahla, Moradi Yousef, Hoorsan Roza, Jesmi Fatemeh

机构信息

Department of Nursing and Midwifery, Islamic Azad University Sanandaj Branch, Sanandaj, Iran.

出版信息

J Prev Med Public Health. 2017 Nov;50(6):347-360. doi: 10.3961/jpmph.16.122.

Abstract

OBJECTIVES

This meta-analysis aimed to evaluate congenital malformations in infants conceived by assisted reproductive techniques (ART), compared with infants conceived spontaneously.

METHODS

In this study, available resources searched to find relevant articles included PubMed, ScienceDirect, Scopus, Google Scholar, Cochrane, ProQuest, Iranmedex, Magiran, and Scientific Information Database. After extracting the necessary information from evaluated articles, meta-analysis on the articles' data was performed using Stata version 11.2.

RESULTS

In this study, from a total of 339 articles, extracted from the initial investigation, ultimately 30 articles were selected for meta-analysis that assessed the use of ART on the risk of congenital abnormalities and some birth complications on 5 470 181 infants (315 402 cases and 5 154 779 controls). The odds ratio (95% confidence interval [CI]) for low birth weight was 1.89 (95% CI, 1.36 to 2.62), preterm labor 1.79 (95% CI, 1.21 to 2.63), cardiac abnormalities 1.43 (95% CI, 1.27 to 1.62), central nervous system abnormalities 1.36 (95% CI, 1.10 to 1.70), urogenital system abnormalities 1.58 (95% CI, 1.28 to 1.94), musculoskeletal disorders 1.35 (95% CI, 1.12 to 1.64), and chromosomal abnormalities in infants conceived by ART was 1.14 (95% CI, 0.90 to 1.44), which were all statistically significant, except chromosomal abnormalities.

CONCLUSIONS

The risk of congenital abnormalities and some birth complications were significantly higher in ART than normal conception, while chromosomal abnormalities were not; therefore, the application of ART should be selected individually for patients by detailed assessment to reduce such risks in the population.

摘要

目的

本荟萃分析旨在评估通过辅助生殖技术(ART)受孕的婴儿与自然受孕的婴儿相比的先天性畸形情况。

方法

在本研究中,通过搜索可用资源以查找相关文章,包括PubMed、ScienceDirect、Scopus、谷歌学术、Cochrane、ProQuest、Iranmedex、Magiran和科学信息数据库。从评估的文章中提取必要信息后,使用Stata 11.2版本对文章数据进行荟萃分析。

结果

在本研究中,从初步检索的总共339篇文章中,最终选择了30篇文章进行荟萃分析,这些文章评估了ART对5470181名婴儿(315402例病例和5154779名对照)先天性异常风险和一些出生并发症的影响。ART受孕婴儿低出生体重的优势比(95%置信区间[CI])为1.89(95%CI,1.36至2.62),早产为1.79(95%CI,1.21至2.63),心脏异常为1.43(95%CI,1.27至1.62),中枢神经系统异常为1.36(95%CI,1.10至1.70),泌尿生殖系统异常为1.58(95%CI,1.28至1.94),肌肉骨骼疾病为1.35(95%CI,1.12至1.64),染色体异常为1.14(95%CI,0.90至1.44),除染色体异常外,所有这些均具有统计学意义。

结论

ART受孕的先天性异常和一些出生并发症的风险显著高于正常受孕,但染色体异常并非如此;因此,应通过详细评估为患者个体化选择ART的应用,以降低人群中的此类风险。

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