受精-胚胎移植后评估出生缺陷的最佳随访时间：中国一项多中心 5 年队列研究。
Optimal Follow-Up Duration for Assessment of Birth Defects After Fertilization-Embryo Transfer: A Multicenter 5-Year Cohort Study in China.
机构信息
Center for Reproductive Medicine, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
Reproductive Medicine Center, Jiangmen Central Hospital, Affiliated Hospital of Sun Yat-sen University, Jiangmen, China.
出版信息
Front Endocrinol (Lausanne). 2022 Mar 18;13:817397. doi: 10.3389/fendo.2022.817397. eCollection 2022.
OBJECTIVE
To investigate the impact of a 5-year follow-up on the incidence of identified birth defects in children conceived using assisted reproductive technologies (ART).
METHODS
A 5-year cohort study was performed in three ART centers from January 2013 to October 2018. 1,543 women with 1,985 infants who delivered successfully or underwent termination of pregnancy due to malformations were recruited in this study. Follow-up was conducted by phone interview, 7 days, 1 year, 3 years, and 5 years after birth. Collected data included whether one or more birth defects were diagnosed, the category of birth defects, and when the malformation was diagnosed. Cumulative incidence of birth defects and the loss to follow-up rate of each follow-up was compared.
RESULTS
According to the diagnostic criterion of birth defects, 111 cases of one or more birth defects were recorded, with a total of 117 birth defects after the 5-year follow-up. 0.2% (4/1,985) of birth defects were diagnosed before delivery; 2.7% (54/1,985) at 7 days; 5.0% (100/1,985) after 1 year; 5.5% (109/1,985) after 3 years; and 5.6% (111/1,985) after 5 years. 3.4% (4/117) of defects were diagnosed prenatally, 45.3% (53/117) of defects diagnosed within the first 7 days after delivery, 40.2% (47/117) diagnosed during 7 days to 1 year, and 9.4% (11/117) of defects diagnosed in 1-3 years after birth. The remaining 1.7% (2/117) of defects were diagnosed between the ages of 3 and 5 years. Among the 1,543 patients, 99.9% patients (1,542/1,543) responded to the telephone interview at 7 days after delivery; the response rate was 89.0% (1,373/1,543) at 1 year, 81% (1,250/1,543) at 3 years, and 64.5% (995/1,543) after 5 years.
CONCLUSION
We suggest that in ART, 1-year follow-up should be the minimum requirement and 3-year follow up the optimal length of follow-up that balances resource requirements with ascertainment completeness.
目的
探讨 5 年随访对辅助生殖技术（ART）受孕儿童出生缺陷发生率的影响。
方法
本研究为 2013 年 1 月至 2018 年 10 月在三个 ART 中心进行的 5 年队列研究。共招募了 1543 名成功分娩或因畸形而终止妊娠的妇女，她们的 1985 名婴儿纳入了该研究。通过电话访谈进行随访，在出生后 7 天、1 年、3 年和 5 年进行随访。收集的数据包括是否诊断出一个或多个出生缺陷、出生缺陷的类别以及畸形的诊断时间。比较了每个随访的累积出生缺陷发生率和失访率。
结果
根据出生缺陷的诊断标准，记录了 111 例一个或多个出生缺陷，5 年后共诊断出 117 例出生缺陷。0.2%（4/1985）的出生缺陷在分娩前诊断；7 天内为 2.7%（54/1985）；1 年后为 5.0%（100/1985）；3 年后为 5.5%（109/1985）；5 年后为 5.6%（111/1985）。3.4%（4/117）的缺陷在产前诊断，45.3%（53/117）的缺陷在分娩后 7 天内诊断，40.2%（47/117）的缺陷在 7 天至 1 年内诊断，9.4%（11/117）的缺陷在出生后 1-3 年内诊断。其余 1.7%（2/117）的缺陷在 3 至 5 岁之间诊断。在 1543 名患者中，99.9%（1542/1543）的患者在分娩后 7 天接受了电话访谈；1 年后的应答率为 89.0%（1373/1543），3 年后为 81.0%（1250/1543），5 年后为 64.5%（995/1543）。
结论
我们建议，在 ART 中，1 年随访应作为最低要求，3 年随访应作为平衡资源需求与完整性的最佳随访时间。
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