生育状况和儿童心血管疾病的风险:基于人口的嵌套病例对照研究
Shiue-Shan Weng1, Yen-Tsung Huang2, Yi-Ting Huang2
1Institute of Public Health, National Yang Ming Chiao Tung University, Taipei City, Taiwan.
Human reproduction (Oxford, England)
|August 21, 2025
概括
通过体外受精 (IVF) 怀孕的孩子和生育不良父母的孩子面临着先天性心脏缺陷的风险. 这种风险部分归因于多胎妊娠,强调了针对性查的必要性.
科学领域:
- 心血管健康
- 儿童心脏病学
- 生殖医学
背景情况:
- 在体外受精 (IVF) 与儿童的血管过早衰老有关.
- 父母生育状况,试管婴儿和儿童心血管疾病 (CVD) 之间的联系尚未得到充分证实.
- 围产因素可能会调解生育状态与儿童心血管疾病之间的关系.
研究的目的:
- 调查父母生育状况 (生育,不完全生育,试管婴儿) 与0-13岁后代患心血管疾病 (CVD) 的风险之间的联系.
- 确定围产因素是否介导了这种关联.
- 评估特定心脏病的风险,包括先天性心脏缺陷,高血压疾病,心肌病和心律失常.
主要方法:
- 在台湾 (2004-2017) 采用2,228,073个父子三位一体的注册数据进行了全国性的基于人口的嵌套病例对照研究.
- 后代分为肥沃,不肥沃和试管婴儿组.
- 41,113名患有儿科心血管疾病的儿童与169,850名对照人群进行了匹配.
- 使用条件后勤回归和因果调解分析.
主要成果:
- 与生育组相比,试管婴儿受孕与先天性心脏缺陷的风险显著增加 (OR,1. 72).
- 与生育不良组相比,低生育率也增加了先天性心脏缺陷的风险 (OR,1.19).
- 多次怀孕解释了试管婴儿与先天性心脏缺陷之间的相关性 (31-54%).
结论:
- 通过试管婴儿受孕的孩子和出生于不孕不育的父母的孩子有先天性心脏缺陷的高风险,部分原因是多次怀孕.
- 减少多胎妊娠可能会减轻与试管婴儿相关的先天性心脏缺陷风险.
- 建议在IVF怀孕中进行胎儿心声检查,特别是那些怀孕多次的孕妇.
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