Is oocyte donation a risk factor for preeclampsia? A systematic review and meta-analysis
Is oocyte donation a risk factor for preeclampsia? A systematic review and meta-analysis
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DOI：
10.1007/s10815-016-0701-9
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发表时间：
2016-07-01
影响因子：
3.1
通讯作者：
Vernaeve, Valerie
中科院分区：
文献类型：
--
作者：
Blazquez, Anna;Garcia, Desiree;Vernaeve, Valerie
这项荟萃分析的目的是确定与自体卵母细胞体外受精（IVF）相比，卵母细胞捐赠（OD）妊娠是否有更高的先兆子痫（PE）发生率。进行系统回顾，以确定1994年1月至2015年4月发表的相关研究，至少有一个英文摘要，使用PubMed，ISI Web of Knowledge，本系统性综述中纳入的11项研究是回顾性和前瞻性队列研究，报告了卵子捐赠与体外受精之间关系的结果与IVF周期相比，卵母细胞捐献是PE发生的危险因素，固定效应法下的加权OR为3.12（FEM：研究之间无异质性）。随机效应模型下的加权OR为2.9（REM：研究之间的异质性）。荟萃回归分析显示，多胎妊娠（估计值= 0.08; p = 0.19）和患者年龄（估计值= -2.29; p = 0.13）均不能显著解释卵母细胞捐献对PE影响的变异性。Q统计值为12.78（p = 0.237），表明两项研究之间不存在异质性。与使用自身卵母细胞进行体外受精相比，捐赠卵母细胞获得的妊娠发生PE的可能性增加了3倍。医生应该意识到这种风险，以便为患者提供咨询并相应地监测妊娠。
The objective of this meta-analysis is to determine whether there is a higher incidence of preeclampsia (PE) in pregnancies achieved by oocyte donation (OD) compared with pregnancies achieved by in vitro fertilization with autologous oocytes (IVF).A systematic review was performed to identify relevant studies published from January 1994 until April 2015 with at least an abstract in English using PubMed, ISI Web of Knowledge, and clinicaltrials.gov. The 11 studies included in this systematic review were retrospective and prospective cohort studies of women reporting results on the association between oocyte donation vs. in vitro fertilization (exposure) and preeclampsia (outcome).Oocyte donation is a risk factor for the development of PE compared to IVF cycles, with a weighted OR of 3.12 under a fixed effects method (FEM: no heterogeneity between the studies). The weighted OR under a random effects model was 2.9 (REM: heterogeneity between the studies). The meta-regression analysis showed that neither multiple pregnancies (estimate = 0.08; p = 0.19) nor patient age (estimate = -2.29; p = 0.13) significantly explained the variability of the effect of oocyte donation on PE. Q statistic was 12.78 (p = 0.237), suggesting absence of heterogeneity between the studies.Pregnancies achieved by oocyte donation confer a threefold increase in the likelihood of developing PE than those achieved by in vitro fertilization with own oocytes. Physicians should be aware of this risk in order to both counsel patients and monitor pregnancies accordingly.