Why do singletons conceived after assisted reproduction technology have adverse perinatal outcome? Systematic review and meta-analysis

医学 荟萃分析 产科 怀孕 繁殖 妇科 辅助生殖技术 不育 内科学 遗传学 生物
作者
Anja Pinborg,Ulla‐Britt Wennerholm,Liv Bente Romundstad,Anne Loft,Kristiina Aittomäki,Viveca Söderström‐Anttila,K. G. Nygren,Johan Hazekamp,Christina Bergh
出处
期刊:Human Reproduction Update [Oxford University Press]
卷期号:19 (2): 87-104 被引量:638
标识
DOI:10.1093/humupd/dms044
摘要

Assisted reproduction technology (ART) is used worldwide, at increasing rates, and data show that some adverse outcomes occur more frequently than following spontaneous conception (SC). Possible explanatory factors for the well-known adverse perinatal outcome in ART singletons were evaluated. PubMed and Cochrane databases from 1982 to 2012 were searched. Studies using donor or frozen oocytes were excluded, as well as those with no control group or including <100 children. The main outcome measure was preterm birth (PTB defined as delivery <37 weeks of gestation), and a random effects model was used for meta-analyses of PTB. Other outcomes were very PTB, low-birthweight (LBW), very LBW, small for gestational age and perinatal mortality. The search returned 1255 articles and 65 of these met the inclusion criteria. The following were identified as predictors for PTB in singletons: SC in couples with time to pregnancy (TTP) > 1 year versus SC singletons in couples with TTP ≤ 1 year [adjusted odds ratio (AOR) 1.35, 95% confidence interval (CI) 1.22, 1.50]; IVF/ICSI versus SC singletons from subfertile couples (TTP > 1 year; AOR 1.55, 95% CI 1.30, 1.85); conception after ovulation induction and/or intrauterine insemination versus SC singletons where TTP ≤ 1 year (AOR 1.45, 95% CI 1.21, 1.74); IVF/ICSI singletons versus their non-ART singleton siblings (AOR 1.27, 95% CI 1.08, 1.49). The risk of PTB in singletons with a 'vanishing co-twin' versus from a single gestation was AOR of 1.73 (95% CI 1.54, 1.94) in the narrative data. ICSI versus IVF (AOR 0.80, 95% CI 0.69–0.93), and frozen embryo transfer versus fresh embryo transfer (AOR 0.85, 95% CI 0.76, 0.94) were associated with a lower risk of PTB. Subfertility is a major risk factor for adverse perinatal outcome in ART singletons, however, even in the same mother an ART singleton has a poorer outcome than the non-ART sibling; hence, factors related to the hormone stimulation and/or IVF methods per se also may play a part. Further research is required into mechanisms of epigenetic modification in human embryos and the effects of cryopreservation on this, whether milder ovarian stimulation regimens can improve embryo quality and endometrial conditions, and whether longer culture times for embryos has a negative influence on the perinatal outcome.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
jiang完成签到,获得积分10
1秒前
bkagyin应助罗氏集团采纳,获得10
2秒前
HH1202完成签到 ,获得积分10
3秒前
wnll发布了新的文献求助10
3秒前
ethan2801完成签到,获得积分10
4秒前
甜晞完成签到,获得积分10
4秒前
米粥饭完成签到,获得积分10
4秒前
LIKUN完成签到,获得积分10
5秒前
djdh完成签到 ,获得积分10
5秒前
小高同学完成签到,获得积分20
5秒前
sxx完成签到,获得积分10
7秒前
阝火火完成签到,获得积分10
8秒前
上官若男应助吱吱采纳,获得10
9秒前
淡定雅山完成签到,获得积分10
9秒前
养头猪饿了吃完成签到,获得积分10
12秒前
tommyliu完成签到,获得积分10
15秒前
yarkye完成签到,获得积分10
15秒前
charih完成签到 ,获得积分10
15秒前
Lisztan完成签到,获得积分10
15秒前
Xtals完成签到,获得积分10
16秒前
18秒前
清脆代桃完成签到 ,获得积分10
19秒前
22秒前
wfy完成签到,获得积分10
22秒前
搜嘎发布了新的文献求助10
23秒前
23秒前
wujuan完成签到 ,获得积分10
24秒前
儒雅的焦完成签到 ,获得积分10
24秒前
默默完成签到,获得积分10
27秒前
蓝桉完成签到 ,获得积分10
27秒前
斗图不怕输完成签到,获得积分10
28秒前
夜信完成签到,获得积分10
29秒前
瀚子完成签到,获得积分0
31秒前
往返完成签到,获得积分10
32秒前
幽默尔蓝发布了新的文献求助10
33秒前
33秒前
白兰鸽完成签到 ,获得积分10
35秒前
35秒前
C2750完成签到,获得积分10
36秒前
自然的菲鹰完成签到,获得积分10
37秒前
高分求助中
Aspects of Babylonian celestial divination : the lunar eclipse tablets of enuma anu enlil 1500
中央政治學校研究部新政治月刊社出版之《新政治》(第二卷第四期) 1000
Hopemont Capacity Assessment Interview manual and scoring guide 1000
Classics in Total Synthesis IV: New Targets, Strategies, Methods 1000
Mantids of the euro-mediterranean area 600
Mantodea of the World: Species Catalog Andrew M 500
Insecta 2. Blattodea, Mantodea, Isoptera, Grylloblattodea, Phasmatodea, Dermaptera and Embioptera 500
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 内科学 物理 纳米技术 计算机科学 基因 遗传学 化学工程 复合材料 免疫学 物理化学 细胞生物学 催化作用 病理
热门帖子
关注 科研通微信公众号,转发送积分 3434871
求助须知:如何正确求助?哪些是违规求助? 3032199
关于积分的说明 8944583
捐赠科研通 2720149
什么是DOI,文献DOI怎么找? 1492192
科研通“疑难数据库(出版商)”最低求助积分说明 689725
邀请新用户注册赠送积分活动 685877