在瑞典,使用辅助生殖技术怀孕的儿童的印记障碍
Mujin Ye1, Arturo Reyes Palomares2, Erik Iwarsson3
1Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Fertility and sterility
|June 2, 2024
概括
辅助生殖技术 (ART) 可能会增加像贝克威斯-维德曼综合征 (BWS) 和普拉德-威利/银-拉塞尔综合征 (PWS/SRS) 这样的印记疾病的风险. 特定的ART方法,如冷胚胎的ICSI,在儿童中显示出更高的风险.
科学领域:
- 生殖医学和遗传学
- 儿科内分泌学 儿科内分泌学
- 人类胚胎学 人类胚胎学
背景情况:
- 印记障碍是一种影响儿童发育的罕见遗传疾病.
- 辅助生殖技术 (ART) 涉及各种受孕方法.
- 需要进一步研究ART和印记障碍之间的关联,考虑到父母不孕症因素.
研究的目的:
- 评估ART怀孕和儿童印记障碍之间的关联.
- 评估父母不育因素对这种关联的影响.
- 确定可能与增加风险相关的特定ART方法.
主要方法:
- 一个全国性的瑞典基于登记册的队列研究.
- 包括超过200万个活生生的独生子 (1997-2017年).
- 使用ICD-10代码识别印记障碍 (BWS,PWS,SRS) 的情况.
- 使用Cox模型的统计分析,使用逆概率治疗权重来调整混因素.
主要成果:
- 通过ART怀孕的儿童总体患印记障碍的风险较高 (HR 1.84).
- 在调整了父母因素 (wHR 1.50) 和不育夫妇 (wHR 1.52) 之后,这种关联仍然存在.
- 内细胞质精子注射 (ICSI) 和冷胚胎的联合使用与PWS/SRS (wHR 4.60) 和BWS (wHR 6.69) 的显著更高风险有关.
结论:
- 与ART怀孕相关的是印记障碍的风险增加,包括PWS/SRS和BWS.
- 对ICSI和冷保存胚胎的联合使用似乎是一个显著的风险因素.
- 这些风险是独立于父母不育背景观察到的.
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