队列研究概况：英国一项全国性基于人群的辅助受孕后出生的儿童队列研究（1992-2009 年）：方法学和出生体重分析。

Cohort profile: a national, population-based cohort of children born after assisted conception in the UK (1992-2009): methodology and birthweight analysis.

机构信息

Population, Policy & Practice Department, UCL Great Ormond Street Institute of Child Health Population Policy and Practice, London, UK

Division of Population Health, Health Services Research & Primary Care, University of Manchester, Manchester, UK.

出版信息

BMJ Open. 2021 Jul 19;11(7):e050931. doi: 10.1136/bmjopen-2021-050931.

DOI:10.1136/bmjopen-2021-050931

PMID:34281932

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8291329/

Abstract

PURPOSE

To generate a large cohort of children born after assisted reproductive technology (ART) in the UK between 1992 and 2009, their naturally conceived siblings (NCS) and matched naturally conceived population (NCP) controls and linking this with health outcome data to allow exploration of the effects of ART. The effects of fresh and frozen embryo transfer on birth weight (BW) were analysed to test the validity of the cohort.

PARTICIPANTS

Children recorded on the Human Fertilisation and Embryology Authority (HFEA) register as being born after ART between 1992 and 2009, their NCS and matched NCP controls linked to Office for National Statistics birth registration dataset (HFEA-ONS cohort). This cohort was further linked to the UK Hospital Episode Statistics database to allow monitoring of the child's post-natal health outcomes up to 2015 (HFEA-ONS-HES subcohort).

FINDINGS TO DATE

The HFEA-ONS cohort consisted of 75 348 children born after non-donor ART carried out in the UK between 1 April 1992 and 31 July 2009 and successfully linked to birth registration records, 14 763 NCS and 164 823 matched NCP controls. The HFEA-ONS-HES subcohort included 63 877 ART, 11 343 NCS and 127 544 matched NCP controls further linked to health outcome data. The exemplar analysis showed that children born after fresh embryo transfers were lighter (BW difference: -131 g, 95% CI: -140 to -123) and those born after frozen embryo transfers were heavier (BW difference: 35 g, 95% CI: 19 to 52) than the NCP controls. The within-sibling analyses were directionally consistent with the population control analyses, but attenuated markedly for the fresh versus natural conception (BW difference: -54 g; 95% CI: -72 to -36) and increased markedly for the frozen versus natural conception (BW difference: 152 g; 95% CI: 113 to 190) analyses.

FUTURE PLANS

To use this cohort to explore the relationship between ART conception and short-term and long-term health outcomes in offspring.

摘要

目的

在英国，于 1992 年至 2009 年期间，通过辅助生殖技术（ART）生育的大量儿童，及其自然受孕的兄弟姐妹（NCS）和匹配的自然受孕人群（NCP）对照组，并将其与健康结果数据相联系，以探索 ART 的影响。为了验证队列的有效性，分析了新鲜胚胎和冷冻胚胎移植对出生体重（BW）的影响。

参与者

在人类受精和胚胎管理局（HFEA）登记册上记录的在 1992 年至 2009 年期间通过 ART 出生的儿童、其 NCS 和匹配的 NCP 对照组与国家统计局出生登记数据集（HFEA-ONS 队列）相联系。该队列还与英国医院发病统计数据库进一步联系，以监测儿童 2015 年前的产后健康结果（HFEA-ONS-HES 子队列）。

迄今为止的发现

HFEA-ONS 队列包括 75348 名儿童，他们在 1992 年 4 月 1 日至 2009 年 7 月 31 日期间在英国进行了非捐赠者的 ART，并且与出生登记记录、14763 名 NCS 和 164823 名匹配的 NCP 对照组成功联系。HFEA-ONS-HES 子队列包括 63877 名 ART、11343 名 NCS 和 127544 名匹配的 NCP 对照组，这些对照组进一步与健康结果数据联系起来。范例分析表明，与 NCP 对照组相比，通过新鲜胚胎移植出生的婴儿体重较轻（BW 差异：-131g，95%CI：-140 至-123），而通过冷冻胚胎移植出生的婴儿体重较重（BW 差异：35g，95%CI：19 至 52）。在兄弟姐妹内的分析与人群对照分析的方向一致，但新鲜胚胎与自然受孕的分析明显减弱（BW 差异：-54g，95%CI：-72 至-36），而冷冻胚胎与自然受孕的分析明显增强（BW 差异：152g，95%CI：113 至 190）。