Ophthalmology Department, The 6th Medical Centre of Chinese People's Liberation Army General Hospital, Beijing 100048, China.
Biomed Res Int. 2019 Jul 11;2019:2095730. doi: 10.1155/2019/2095730. eCollection 2019.
Currently, the use of assisted reproductive technology (ART) is increasing. Because of the poor prognosis of retinopathy of prematurity (ROP), the association between ART and the ROP has been explored in several studies, but the result was still inconclusive. Conducting a meta-analysis, we evaluated the risk of ROP in relation to the ART. Subgroup analysis as well as groups with different embryo numbers and different ROP stages was further analyzed. The PubMed, Embase, and Cochrane Library databases were searched for studies recording data about both the use of ART and ROP occurrence simultaneously. Odds ratios (ORs) and 95% confidence interval (95%CI) were calculated to analyze the association by using random- or fixed-effect models based on heterogeneity test. In total 15 observational studies containing 10392 ART cases and 39474 spontaneous conception cases were included. Results showed that there was a significant association between the use of ART and ROP occurrence in the offspring (OR = 1.34, 95% CI: 1.05 to 1.73, P = 0.02). With subgroup analysis, we found that the influence actually came from a subgroup of ART, the fertilization (IVF). Moreover, there was a significant association between ART and ROP in singletons. Though insignificant, the ORs were larger than 1 in the analysis between ART and stage 1 and 2 ROP. But ART showed significant association with stage 3 ROP. Our study preliminarily indicated that the use of IVF was associated with higher risk of ROP occurrence. And ART is more likely to result in severe ROP and ROP in singletons. Further specific, high-quality studies with large sample size are still needed to draw more precise conclusion.
目前，辅助生殖技术（ART）的应用正在增加。由于早产儿视网膜病变（ROP）的预后较差，因此已经有几项研究探讨了 ART 与 ROP 之间的关系，但结果仍不确定。我们进行了荟萃分析，评估了与 ART 相关的 ROP 风险。进一步进行了亚组分析以及胚胎数量和 ROP 分期不同的组的分析。检索了 PubMed、Embase 和 Cochrane Library 数据库，以查找同时记录 ART 使用和 ROP 发生数据的研究。根据异质性检验，使用随机或固定效应模型计算优势比（OR）和 95％置信区间（95％CI），以分析相关性。共纳入了 15 项包含 10392 例 ART 病例和 39474 例自然受孕病例的观察性研究。结果表明，ART 的使用与后代 ROP 的发生之间存在显著相关性（OR=1.34，95％CI：1.05 至 1.73，P=0.02）。通过亚组分析，我们发现这种影响实际上来自于 ART 的一个亚组，即受精（IVF）。此外，ART 与单胎 ROP 之间也存在显著相关性。尽管无统计学意义，但在分析 ART 与 1 期和 2 期 ROP 之间的 OR 大于 1。但是 ART 与 3 期 ROP 有显著相关性。我们的研究初步表明，使用 IVF 与 ROP 发生的风险增加有关。而且 ART 更有可能导致严重的 ROP 和单胎 ROP。还需要进一步进行具体的、高质量的大样本研究，以得出更精确的结论。
