通过辅助生殖技术怀孕的儿童观察到的先天性异常 - 一项系统性审查和元分析
Paripoorna Bhat1, Vijay Shree Dhyani2, Vani Lakshmi3
1Division of Reproductive Genetics, Department of Reproductive Science, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.
Journal of assisted reproduction and genetics
|March 31, 2025
概括
通过辅助生殖技术 (ART) 怀孕的儿童患先天性异常 (CA) 的风险略高. 这一系统性审查强调了需要改进ART方法和对ART受孕儿童的监测.
科学领域:
- 生殖医学 生殖医学
- 儿科健康 儿科健康
- 遗传学和发育生物学
背景情况:
- 先天性异常 (CAs) 是围产和儿童死亡的一个重要原因.
- 辅助生殖技术 (ART) 的使用正在增加,需要对ART所产生的儿童健康结果进行研究.
- 现有的关于在ART怀孕的儿童中CA发生率的数据需要全面的综合.
研究的目的:
- 系统地审查和元分析与自发怀孕 (SC) 儿童相比,在ART怀孕的儿童中发生CA的发生率.
- 确定特定的ART方法,与较高的CA风险相关.
- 为临床实践和未来研究方向提供信息.
主要方法:
- 按照PRISMA 2020指南进行系统审查和元分析.
- 包括113项具有大量队列的研究:768,929名ART受孕儿童和40,709,337名SC儿童.
- 基于ART技术的子组分析 (例如ICSI,试管婴儿,胚胎移植类型和时间).
主要成果:
- 与SC儿童相比,ART孕育的儿童患CA的风险略高.
- 亚组分析表明,在细胞内精子注射 (ICSI),第3天胚胎移植和新鲜胚胎移植 (ET) 时,CA风险增加.
- 试管婴儿 (IVF),第五天移植和冷胚胎移植 (FET) 与相对较低的风险相关.
结论:
- 与自发怀孕的儿童相比,在ART怀孕的儿童中观察到CA的发病率略有增加.
- 特定的ART协议,包括ICSI和新鲜胚胎移植,可能与先天性异常的更高风险有关.
- 加强对ART技术的监测和改进对于减轻ART怀孕后代的AC风险至关重要.
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