辅助生殖和先天性形:系统性审查和元分析
Meenakshi Veeramani1, Neerujah Balachandren2, Yong Hwa Hong3
1School of Medicine, Imperial College London, London, UK.
Congenital anomalies
|April 5, 2024
概括
通过辅助生殖受孕的新生儿增加了重大先天性异常风险. 内细胞质精子注射 (ICSI) 与体外受精 (IVF) 相比,显示出更高的泌尿器官和肌肉骨异常风险.
科学领域:
- 生殖医学 生殖医学
- 儿科健康 儿科健康
- 医学遗传学 医学遗传学
背景情况:
- 辅助生殖技术 (ART) 在全球越来越多地使用.
- 以前的研究表明,ART与先天性异常之间存在潜在的联系.
- 与不同的ART方法相关的具体风险尚不清楚.
研究的目的:
- 确定包括体外受精 (IVF) 和细胞内精子注射 (ICSI) 在内的ART是否与重大先天性异常的风险增加有关.
- 调查特定的器官系统是否会因ART相关异常而受到不成比例的影响.
- 为了比较ICSI和试管婴儿怀孕之间的先天性异常风险.
主要方法:
- 从研究开始到2023年2月发表的综合元分析.
- 包括来自6个数据库和2个注册表的数据.
- 通过基于研究重量,偏差风险和地理位置的子组分析来探索异质性.
主要成果:
- 通过ART怀孕的新生儿与自然怀孕的新生儿相比,具有更高的重大先天性异常风险 (OR 0.67 [95% CI 0.59,0.76]).
- 内细胞质精子注射 (ICSI) 与异常的风险比体外受精 (IVF) 高9%.
- 在ICSI中,泌尿器官和肌肉骨异常与试管婴儿怀孕相比显著增加 (分别为OR 0.83 [95% CI 0.69, 0.98]和OR 0.65 [95% CI 0.49, 0.85]).
- 心脏,胃肠道和神经系统异常的风险增加似乎独立于特定的ART方法.
结论:
- 辅助生殖技术与新生儿出现重大先天性异常的风险增加有关.
- 内细胞质精子注射 (ICSI) 与体外受精 (IVF) 相比,具有更高的风险,特别是在泌尿器官和肌肉骨缺陷方面.
- 虽然心脏,神经和胃肠道异常通常在ART中增加,但泌尿器官和肌肉骨异常显示出技术特异性关联.
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