Incidence of congenital malformations in children born after ICSI.
Incidence of congenital malformations in children born after ICSI.
复制标题
ICSI 后出生的儿童先天性畸形的发生率。
作者：
U. Wennerholm;C. Bergh;L. Hamberger;K. Lundin;L. Nilsson;M. Wikland;B. Källén
本研究的目的是确定胞浆内单精子注射 (ICSI) 后出生的完整儿童队列中先天畸形的发生率。检索了1139名婴儿、736名单胎、200对双胞胎和1对三胞胎的医疗记录。发现异常的婴儿总数为 87 名（7.6%），其中 40 名为轻微异常。还使用瑞典医学出生登记处和先天畸形登记处的数据，将 ICSI 后出生的儿童的畸形发生率与瑞典所有出生的儿童进行了比较。对于 ICSI 儿童，根据分娩医院、出生年份和产妇年龄进行分层后，出现任何严重或轻微畸形的比值比 (OR) 为 1.75 [95% 置信区间 (CI) 1.19-2.58]。如果还对单胎/双胞胎进行分层，OR 会降低至 1.19 (95% CI 0.79-1.81)。因此，先天性畸形发生率的增加主要是多胎出生率高的结果。在 ICSI 后出生的儿童中发现过多发生的唯一特定畸形是尿道下裂（相对风险 3.0，确切 95% CI 1. 09-6.50），这可能与父亲生育力低下有关。
The aim of this study was to determine the incidence of congenital malformations in a complete cohort of children born after intracytoplasmic sperm injection (ICSI). The medical records were retrieved for 1139 infants, 736 singletons, 200 sets of twins and one set of triplets. The total number of infants with an identified anomaly was 87 (7.6%), 40 of which were minor. The incidence of malformations in children born after ICSI was also compared with all births in Sweden using data from the Swedish Medical Birth Registry and the Registry of Congenital Malformations. For ICSI children, the odds ratio (OR) for having any major or minor malformation was 1.75 [95% confidence interval (CI) 1.19-2.58] after stratification for delivery hospital, year of birth and maternal age. If stratification for singletons/twins was also done, the OR was reduced to 1.19 (95% CI 0.79-1.81). The increased rate of congenital malformations is thus mainly a result of a high rate of multiple births. The only specific malformation which was found to occur in excess in children born after ICSI was hypospadias (relative risk 3.0, exact 95% CI 1. 09-6.50) which may be related to paternal subfertility.