Vital Statistical Department, Institute of Health Information, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336, People's Republic of China.
School of Public Health, Fudan University, Shanghai, People's Republic of China.
Sci Rep. 2022 Mar 16;12(1):4528. doi: 10.1038/s41598-022-08707-x.
Infants conceived with in vitro fertilization (IVF) are exposed to underlying infertility and the IVF process. High risks of adverse birth outcomes (ABOs) were observed among these infants, including preterm birth, low birth weight, macrosomia, being large/small for gestational age (LGA/SGA). It is unclear whether the specific etiology of the rise of ABOs among IVF infants is IVF technology itself or underlying infertility. A total of 9,480 singletons conceived with IVF and 1,952,419 singletons from the general population were obtained in this study. Multivariable logistic regression model was used to assess variations in risk of ABOs according to causes of infertility. Poisson distributions were applied to calculate standardized risk ratios of IVF infants vs. general population after controlling the causes of infertility. Higher risk of preterm birth and low birth weight were observed among parents with polycystic ovary syndrome, endometriosis, uterine and semen abnormalities. Compared to the general population, after excluding the influence of infertility causes, singletons conceived with IVF were at higher risk of macrosomia (SRR = 1.28, 95% CI 1.14-1.44) and LGA (SRR = 1.25, 95% CI 1.15-1.35). The higher risk of ABOs in IVF was driven by both IVF treatments and infertility, which is important for improving IVF treatments and the managing pregnancies and child development.
本研究纳入了 9480 名接受体外受精（IVF）的单胎婴儿和 1952419 名普通人群单胎婴儿。采用多变量逻辑回归模型评估根据不孕原因的 ABOs 风险变化。应用泊松分布在控制不孕原因后计算 IVF 婴儿与普通人群的标准化风险比。多囊卵巢综合征、子宫内膜异位症、子宫和精液异常的父母所生孩子有更高的早产和低出生体重风险。与普通人群相比，在排除不孕原因的影响后，IVF 受孕的单胎婴儿发生巨大儿的风险更高（SRR=1.28，95%CI1.14-1.44）和 LGA（SRR=1.25，95%CI1.15-1.35）的风险更高。IVF 中 ABOs 的较高风险是由 IVF 治疗和不孕共同驱动的，这对于改善 IVF 治疗以及妊娠和儿童发育管理很重要。
