Zhao Jing, Yan Yi, Huang Xi, Li Yanping
Reproductive Medicine Center, Xiangya Hospital, Central South University, Changsha, Hunan, P. R. China.
J Matern Fetal Neonatal Med. 2020 Jan;33(2):322-333. doi: 10.1080/14767058.2018.1488168. Epub 2018 Sep 6.
: Assisted reproductive technologies (ARTs) have made great progress. However, whether tube baby born after ART were at an increased risk of birth defects is not clear.: To assess whether the ART increases the risk of birth defects in children born after ART.: Medline, Google Scholar, and the Cochrane Library were searched.: Clinical trials that evaluate the risk of birth defect in children born after fertilization (IVF)/intracytoplasmic sperm injection (ICSI) and natural conceptions (NC) were included. The primary outcome was the prevalence of birth defects.: The relative risk was used as the summary measure with random effects model. We assessed heterogeneity between studies using the index.: Totally 46 studies were included. The pooled relative risk (RR) estimated suggested there was an increased risk of birth defects in ART compared with the NC group (RR: 1.40; 95% CI 1.31-1.49). Twenty and fifteen studies were included to compare the risk of birth defects between NC and IVF/ICSI, respectively. The results indicated that both IVF and ICSI increase the risk of birth defects (IVF: RR 1.25; 95% CI 1.12-1.40; ICSI: RR 1.29; 95% CI 1.14-1.45). When subgroup according to plurality, 22 studies assessed the risk of birth defects after ART or NC in singletons and 15 studies evaluated the risk of birth defects in twins. The pooled RRs were 1.41 (95% CI 1.30-1.52) and 1.18 (95% CI 0.98-1.42), respectively.: Children born after ART were at an increased risk of birth defects compared with NC. There was no difference in birth defects risk between ART twins and NC twins.
辅助生殖技术（ARTs）取得了巨大进展。然而，通过ART出生的试管婴儿是否存在出生缺陷风险增加尚不清楚。
为评估ART是否会增加ART出生儿童的出生缺陷风险。
检索了Medline、谷歌学术和考克兰图书馆。
纳入了评估体外受精（IVF）/卵胞浆内单精子注射（ICSI）后出生儿童与自然受孕（NC）出生儿童出生缺陷风险的临床试验。主要结局是出生缺陷的患病率。
采用随机效应模型将相对风险用作汇总指标。我们使用I²指数评估研究间的异质性。
共纳入46项研究。汇总估计的相对风险（RR）表明，与NC组相比，ART出生儿童的出生缺陷风险增加（RR：1.40；95%CI 1.31 - 1.49）。分别纳入20项和15项研究比较NC与IVF/ICSI之间的出生缺陷风险。结果表明，IVF和ICSI均增加出生缺陷风险（IVF：RR 1.25；95%CI 1.12 - 1.40；ICSI：RR 1.29；95%CI 1.14 - 1.45）。按多胎情况进行亚组分析时，22项研究评估了ART或NC后单胎出生缺陷风险，15项研究评估了双胎出生缺陷风险。汇总RR分别为1.41（95%CI 1.30 - 1.52）和1.18（95%CI 0.98 - 1.42）。
与NC相比，ART出生儿童的出生缺陷风险增加。ART双胎和NC双胎的出生缺陷风险无差异。
