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辅助生殖技术与先天性泌尿生殖系统畸形风险:系统评价和荟萃分析。

Assisted reproductive technologies and the risk of congenital urogenital tract malformations: A systematic review and meta-analysis.

机构信息

Department of Urology, Chongqing Medical University Affiliated Children's Hospital, Chongqing, 400010, China; Children's Hospital of Chongqing Medical University, Chongqing, 400010, China.

Department of Urology, Chongqing Medical University Affiliated Children's Hospital, Chongqing, 400010, China; Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400010, China; National Clinical Research Center for Child Health and Disorders, Chongqing, 400010, China; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, 400010, China; Children's Hospital of Chongqing Medical University, Chongqing, 400010, China; Chongqing Key Laboratory of Pediatrics, Chongqing, 400010, China.

出版信息

J Pediatr Urol. 2021 Feb;17(1):9-20. doi: 10.1016/j.jpurol.2020.11.005. Epub 2020 Nov 5.

DOI:10.1016/j.jpurol.2020.11.005
PMID:33223458
Abstract

A systematic review was conducted to evaluate the relationship between ART and the risk of urogenital tract malformations, especially hypospadias and cryptorchidism. Thirty-three papers were selected. Meta-analysis showed that ART was correlated with an increased risk of urogenital tract malformation in offspring (odds ratio (OR) = 1.61, 95% confidence interval (CI): 1.41-1.85), hypospadias (OR = 1.87, 95% CI: 1.47-2.40) and cryptorchidism (OR = 1.83, 95% CI: 1.54-2.18). Among offspring conceived by ART, multiple pregnancies appeared to result in a higher risk of urogenital tract malformation than singleton pregnancies (OR = 1.42, 95% CI: 0.99-2.04; P = 0.058). No significant difference in the risk of urogenital tract malformation was found between in vitro fertilization and intracytoplasmic sperm injection technologies. A sensitivity analysis showed that the above conclusions were relatively consistent. Conclusion: ART is correlated with an increased risk of urogenital tract malformations in offspring, especially hypospadias and cryptorchidism. Among ART offspring, multiple pregnancies may lead to a higher risk of urogenital tract malformations than singleton pregnancies, but more studies are needed for confirmation.

摘要

一项系统评价评估了 ART 与尿生殖道畸形(尤其是尿道下裂和隐睾)风险之间的关系。共纳入 33 篇文献。Meta 分析显示,ART 与后代发生尿生殖道畸形的风险增加相关(比值比(OR)=1.61,95%置信区间(CI):1.41-1.85),包括尿道下裂(OR=1.87,95%CI:1.47-2.40)和隐睾(OR=1.83,95%CI:1.54-2.18)。在接受 ART 受孕的后代中,多胎妊娠似乎比单胎妊娠发生尿生殖道畸形的风险更高(OR=1.42,95%CI:0.99-2.04;P=0.058)。体外受精和胞浆内单精子注射技术之间,尿生殖道畸形的风险无显著差异。敏感性分析表明,上述结论相对一致。结论:ART 与后代发生尿生殖道畸形(尤其是尿道下裂和隐睾)的风险增加相关。在接受 ART 受孕的后代中,多胎妊娠可能比单胎妊娠发生尿生殖道畸形的风险更高,但还需要更多的研究来证实。

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