Conception by assisted reproductive technology in infants with critical congenital heart disease in Japan
Conception by assisted reproductive technology in infants with critical congenital heart disease in Japan
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DOI：
10.1016/j.rbmo.2021.10.005
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发表时间：
2022-01-01
影响因子：
4
通讯作者：
Kato, Taichi
中科院分区：
文献类型：
--
作者：
Morimoto, Yoshihito;Go, Kiyotaka;Kato, Taichi
研究问题：在日本人口中，不同类型的新生儿重症先天性心脏病（CCHD）中，通过辅助生殖技术ART出生的婴儿比例是多少？设计图：回顾性分析了2014年1月至2019年12月期间日本两个儿科中心的418名连续CCHD婴儿，这些婴儿在出生后28天内需要导管治疗或手术或导管依赖性病变。评估每种类型CCHD婴儿中ART的比例。比较了单室性心脏缺损（UVH）与双室性心脏缺损（BVH）婴儿ART的比例。结果：研究组包括229名男孩和189名女孩，胎龄为38 +/- 2周。总的来说，61名婴儿（14.6%）是通过生育治疗受孕的，其中46名（11.0%）是通过ART受孕的。111名婴儿（26.6%）和307名婴儿（73.4%）分别发现了单心室心脏缺陷和BVH。无论母亲年龄和母亲流产史如何，UVH组（16.2%）通过ART受孕的婴儿比例显著高于BVH组（9.1%）（OR 2.28，95%CI 1.11至4.68，P = 0.025）。结论：婴幼儿先天性心脏病中ART的比例较高，尤以UVH为主。这些发现可以形成对ART受孕的胎儿进行胎儿超声心动图检查的基本原理的基础。
Research question: What is the proportion of infants born as a result of assisted reproductive technology ART across different types of neonatal critical congenital heart disease (CCHD) in a Japanese population? Design: A retrospective analysis of 418 consecutive infants with CCHD that required catheter treatment or surgery within the first 28 days of life or ductal-dependent lesions, in two paediatric centres in Japan, between January 2014 and December 2019. The proportion of ART in infants with each type of CCHD was evaluated. The proportion of ART in infants with univentricular heart defect (UVH) compared with those with biventricular heart defect (BVH) was evaluated. Results: The study group included 229 boys and 189 girls, with a gestational age of 38 +/- 2 weeks. Overall, 61 infants (14.6%) were conceived by fertility treatment with 46 (11.0%) conceived by ART. Univentricular heart defect and BVH were identified in 111 infants (26.6%) and 307 infants (73.4%), respectively. The proportion of infants conceived by ART was significantly higher in UVH (16.2%) than in BVH (9.1%) (OR 2.28, 95% CI 1.11 to 4.68, P = 0.025), regardless of maternal age and maternal history of miscarriage. Conclusions: The proportion of ART in infants with CCHD, especially UVH, was high. These findings could form the basis of a rationale for carrying out fetal echocardiography in fetuses conceived by ART.