Shabtai Tal, Sheiner Eyal, Wainstock Tamar, Raziel Arie, Kessous Roy
Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, POB 151, Beer-Sheva 84101, Israel.
The Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel.
J Clin Med. 2023 May 29;12(11):3728. doi: 10.3390/jcm12113728.
Controversy exists in the literature regarding the possible association between infertility treatments in singleton pregnancies and long-term risk for childhood malignancy. Data regarding infertility treatments in twins and long-term childhood malignancies are scarce. We sought to investigate whether twins conceived following infertility treatments are at an increased risk for childhood malignancy. A population-based retrospective cohort study, comparing the risk for future childhood malignancy in twins conceived by infertility treatments (in vitro fertilization and ovulation induction) and those who were conceived spontaneously. Deliveries occurred between the years 1991 and 2021 in a tertiary medical center. A Kaplan-Meier survival curve was used to compare the cumulative incidence of childhood malignancies, and a Cox proportional hazards model was constructed to control for confounders. : During the study period, 11,986 twins met the inclusion criteria; 2910 (24.3%) were born following infertility treatments. No statistically significant differences were noted between the groups comparing the rate (per 1000) of childhood malignancies (2.0 in the infertility treatments group vs. 2.2 in the comparison group, OR 1.04, 95% CI 0.41-2.62; = 0.93). Likewise, the cumulative incidence over time was comparable between the groups (log-rank test, = 0.87). In a Cox regression model, controlling for maternal and gestational age, no significant differences in childhood malignancies were noted between the groups (adjusted HR = 0.82, 95% CI 0.49-1.39, = 0.47). In our population, twins conceived following infertility treatments are not at an increased risk for childhood malignancies.
关于单胎妊娠的不孕治疗与儿童期恶性肿瘤的长期风险之间可能存在的关联,文献中存在争议。关于双胞胎的不孕治疗与儿童期长期恶性肿瘤的数据很少。我们试图调查通过不孕治疗怀上的双胞胎患儿童期恶性肿瘤的风险是否增加。一项基于人群的回顾性队列研究,比较了通过不孕治疗(体外受精和排卵诱导)怀上的双胞胎与自然受孕的双胞胎未来患儿童期恶性肿瘤的风险。分娩发生在1991年至2021年期间的一家三级医疗中心。使用Kaplan-Meier生存曲线比较儿童期恶性肿瘤的累积发病率,并构建Cox比例风险模型以控制混杂因素。在研究期间,11986对双胞胎符合纳入标准;2910对(24.3%)是在不孕治疗后出生的。在比较儿童期恶性肿瘤发生率(每1000例)的组间未发现统计学上的显著差异(不孕治疗组为2.0,对照组为2.2,OR为1.04,95%CI为0.41-2.62;P = 0.93)。同样,两组随时间的累积发病率相当(对数秩检验,P = 0.87)。在Cox回归模型中,控制母亲年龄和孕周后,两组间儿童期恶性肿瘤无显著差异(调整后HR = 0.82,95%CI为0.49-1.39,P = 0.47)。在我们的人群中,通过不孕治疗怀上的双胞胎患儿童期恶性肿瘤的风险没有增加。