Chen Xinyu, Zhou Peihong
Xinyu Chen Department of Reproduction Eleven Ward, Huzhou Maternity & Child health Care Hospital, Huzhou, Zhejiang Province 313000, P.R. China.
Peihong Zhou Department of Gynaecology Thirteen Ward, Huzhou Maternity & Child health Care Hospital, Huzhou, Zhejiang Province 313000, P.R. China.
Pak J Med Sci. 2025 May;41(5):1526-1535. doi: 10.12669/pjms.41.5.11961.
The aim of this study was to evaluate the impact of assisted reproductive technology (ART) on the risk of cerebral palsy (CP) in offspring.
We searched PubMed, Embase, Web of Science and Scopus databases for observational studies that investigated the link between ART and CP as a pregnancy outcome that were published until 15th January, 2024. Only studies that provided adjusted effect sizes for the outcome of interest were included. Pooled odds ratio (OR) was reported along with 95% confidence intervals (CI).
Thirteen studies were included. Pregnancy that was achieved with the help of ART correlated with significantly higher risk of CP in offspring (OR 1.51, 95% CI: 1.18, 1.94) compared to natural conception. The risk of CP in singleton pregnancies achieved through ART was elevated (OR 1.31, 95% CI: 1.09, 1.58). while no such increase in the risk was detected in cases of multiple pregnancies (OR 1.07, 95% CI: 0.95, 1.20) and preterm births (OR 1.09, 95% CI: 0.93, 1.28). Studies published prior to the year 2010 showed an association of ART with elevated rates of CP (OR 1.67, 95% CI: 1.14, 2.44). No difference was detected in studies published after the year 2010 (OR 1.40, 95% CI: 0.97, 2.03).
Our findings suggest a modest increase in the risk of CP that is linked to ART. However, the analysis is hindered by a small number of studies and notable heterogeneity. Subgroup analyses did not show significant associations for multiple or preterm pregnancies, suggesting that other factors beyond ART may be responsible. Factors such as maternal age, underlying infertility, and pregnancy complications might contribute to the observed risk of CP rather than ART itself. Higher-quality studies are required to validate our conclusions.
本研究旨在评估辅助生殖技术（ART）对后代患脑瘫（CP）风险的影响。
我们在PubMed、Embase、Web of Science和Scopus数据库中检索了截至2024年1月15日发表的观察性研究，这些研究调查了ART与作为妊娠结局的CP之间的联系。仅纳入了提供感兴趣结局调整效应量的研究。报告合并比值比（OR）及95%置信区间（CI）。
纳入13项研究。与自然受孕相比，借助ART实现的妊娠与后代患CP的风险显著更高相关（OR 1.51，95%CI：1.18，1.94）。通过ART实现的单胎妊娠患CP的风险升高（OR 1.31，95%CI：1.09，1.58），而在多胎妊娠（OR 1.07, 95%CI：0.95，1.20）和早产（OR 1.09, 95%CI：0.93，1.28）病例中未检测到此类风险增加。2010年前发表的研究显示ART与CP发生率升高相关（OR 1.67，95%CI：1.14，2.44）。2010年后发表的研究未检测到差异（OR 1.40，95%CI：0.97，2.03）。
我们的研究结果表明，与ART相关的CP风险有适度增加。然而，分析受到研究数量少和显著异质性的阻碍。亚组分析未显示多胎或早产妊娠有显著关联，表明可能是ART以外的其他因素所致。诸如产妇年龄、潜在不孕和妊娠并发症等因素可能导致观察到的CP风险，而非ART本身。需要更高质量的研究来验证我们的结论。
