Effects of in vitro fertilization and maternal characteristics on perinatal outcomes: a population-based study using siblings
Effects of in vitro fertilization and maternal characteristics on perinatal outcomes: a population-based study using siblings
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DOI：
10.1016/j.fertnstert.2015.11.015
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发表时间：
2016-03-01
影响因子：
6.7
通讯作者：
Ensing, Sabine
中科院分区：
文献类型：
--
作者：
Seggers, Jorien;Pontesilli, Martina;Ensing, Sabine
目的：研究体外受精与非体外受精连续出生的单胎兄弟姐妹的出生体重，以期从体外受精治疗本身中分离出母亲特征的影响。设计：以人群为基础的研究。地点：不适用。患者(S)：1999年至2007年出生队列中的第一胎和第二胎，包括272,551名双胞胎母亲。干预(S)：无干预；主要结局指标(S)：出生体重。结果(S)：这项研究包括545,102名通过自然受孕(NC)或体外受精出生的儿童，数据集来自以人口为基础的荷兰围产期登记处(PRN)，其中包含怀孕、分娩和新生儿结局的信息。我们使用了两种方法：[1]兄弟姐妹法和[2]兄弟姐妹法。在第一种方法中，我们纳入了四组母亲所生的孩子，这些母亲按以下顺序怀孕(数字表示出生顺序)：NC 1-NC2(参考，n=254,721)、IVF1-NC2(n=1342)、NC1-IVF2(n=471)和IVF1-IVF2(n=687)。为了分别解释试管受精和母体特征的影响，进行了几次比较。在第二种方法中，体外受精儿童(n=1,813)的围产儿结局与他们的非体外受精同胞(n=1,813)的围产儿结局进行了比较。兄弟姐妹间的分析表明，母亲的特征与较低的出生体重之间存在关联，对母亲影响的估计范围从-7克(95%可信区间，-40；26)到-101克(95%可信区间，-170；-32)。无论是兄弟姐妹间的分析，还是兄弟姐妹间的分析，都没有显示体外受精治疗本身的额外不良影响。结论(S)：低生育妇女的母亲特征与较低的出生体重有关。体外受精治疗本身并不会额外降低后代的出生体重。(C)2016年由美国生殖医学会评选。
Objective: To study birthweight in consecutively born sibling singletons conceived with and without in vitro fertilization (IVF) to disentangle the effects of maternal characteristics from those of the IVF treatment itself.Design: Population-based study.Setting: Not applicable.Patient(s): Firstborn and secondborn children from a 9-year birth cohort (1999-2007) comprising of 272,551 women who conceived two siblings.Intervention(s): No intervention; children were conceived naturally or through IVF.Main Outcome Measure(s): Birthweight.Result(s): The study included 545,102 children born by natural conception (NC) or IVF with the data set obtained from the population-based Netherlands Perinatal Registry (PRN) containing information on pregnancies, deliveries, and neonatal outcomes. We used two approaches: [1] the intersibling approach and [2] the sibling-ship approach. In the first approach we included children born to four groups of mothers who conceived in the following order (numbers indicate birth order): NC1-NC2 (reference, n = 254,721), IVF1-NC2 (n = 1342), NC1-IVF2 (n = 471), and IVF1-IVF2 (n = 687). Several comparisons were made to interpret the effects of IVF and maternal characteristics separately. In the second approach, perinatal outcomes of IVF children (n = 1,813) were compared with those of their NC siblings (n = 1,813). The intersibling analyses suggested an association between maternal characteristics and a lower birthweight, with estimates of the maternal effect ranging from -7 g (95% CI, -40; 26) to -101 g (95% CI, -170; -32). Neither the intersibling analyses nor the sibling-ship analyses indicated an additional adverse effect of IVF treatment itself.Conclusion(s): Maternal characteristics of subfertile women are associated with a lower birthweight. In vitro fertilization treatment itself does not additionally contribute to a lower birthweight in the offspring. (C) 2016 by American Society for Reproductive Medicine.