Galdini Alessandro, Fesslova Vlasta M E, Gaeta Gerarda, Candiani Massimo, Pozzoni Mirko, Chiarello Carmelina, Cavoretto Paolo Ivo
Gynecology and Obstetrics Department, IRCCS San Raffaele Hospital, University Vita-Salute, Via Olgettina 60, 20132 Milan, Italy.
Center of Fetal Cardiology, IRCCS Policlinico San Donato, Via Morandi 30, 20097 Milan, Italy.
J Clin Med. 2021 Nov 18;10(22):5363. doi: 10.3390/jcm10225363.
Pregnancies obtained by assisted reproductive technology (ART) are associated with an increased risk of complications and congenital anomalies, particularly congenital heart defects (CHDs). Therefore, our aim is to evaluate, retrospectively, the prevalence of CHD in ART pregnancies in our two centers and analyze their characteristics and outcomes.
Observational study including fetuses conceived by ART referred between June 2011 and September 2020 and undergoing a fetal cardiac ultrasound scan. Cases with genetic, chromosomal abnormalities or extracardiac malformations were excluded. Population included 1511 pregnancies, which consisted of 269 twins and 1242 singletons, 547 IVF (in vitro fertilization), 773 ICSI (intracytoplasmic sperm injection) and 191 oocyte donations (OD).
CHDs were found in 29 fetuses, with an overall prevalence of 1.92% (29/1511), 1.85% (23/1242) in singletons and 2.23% in twins (6/269). Thirteen were IVF, eight ICSI and eight OD cases, with a greater risk of CHD after IVF and OD (IVF: 13/29 (44.8%)-one twin; ICSI: 8/29 (27.6%)-three twins); 22 had major and 7 minor defects. Two pregnancies with a hypoplastic left heart were terminated; the majority of live-born cases needed surgery. Three babies died (two post-surgery, one had a late death).
Our data show an increased prevalence of CHD after ART with a heterogeneous spectrum of diagnoses, mainly major defects.
通过辅助生殖技术（ART）获得的妊娠与并发症及先天性异常风险增加相关，尤其是先天性心脏病（CHD）。因此，我们的目的是回顾性评估我们两个中心ART妊娠中CHD的患病率，并分析其特征和结局。
观察性研究，纳入2011年6月至2020年9月间通过ART受孕并接受胎儿心脏超声扫描的胎儿。排除有遗传、染色体异常或心外畸形的病例。研究人群包括1511例妊娠，其中269例为双胎妊娠，1242例为单胎妊娠，547例为体外受精（IVF），773例为卵胞浆内单精子注射（ICSI），191例为卵母细胞捐赠（OD）。
发现29例胎儿患有CHD，总体患病率为1.92%（29/1511），单胎妊娠患病率为1.85%（23/1242），双胎妊娠患病率为2.23%（6/269）。其中13例为IVF，8例为ICSI，8例为OD病例，IVF和OD后CHD风险更高（IVF：13/29（44.8%） - 1例双胎；ICSI：8/29（27.6%） - 3例双胎）；22例有严重缺陷，7例有轻微缺陷。2例左心发育不全的妊娠终止；大多数活产病例需要手术。3例婴儿死亡（2例术后死亡，1例晚期死亡）。
我们的数据显示ART后CHD患病率增加，诊断范围异质性，主要为严重缺陷。
