Congenital malformations in infants born after IVF:: a population-based study
Congenital malformations in infants born after IVF:: a population-based study
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DOI：
10.1093/humrep/16.3.504
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发表时间：
2001-03-01
影响因子：
6.1
通讯作者：
Källén, B
中科院分区：
文献类型：
--
作者：
Ericson, A;Källén, B
从1982-1997年瑞典IVF后出生的几乎所有婴儿的登记册（n = 9111）中研究了IVF后出生的婴儿先天性畸形的存在。另外64名婴儿仅使用医疗记录进行了研究。这是一项全国性的研究，有一个基于人群的对照组（n = 1 690 577），并考虑了相关的潜在混杂因素。在医疗出生登记处登记的先天性畸形过多（n = 516，优势比= 1.47），但当考虑到混杂因素：出生年份、母亲年龄、胎次和不想要的无子女时间（优势比= 0.89）时，这种过多就消失了。在某些特殊情况下，神经管缺陷、消化道闭锁、脐膨出和尿道下裂（在胞浆内精子注射后）的风险增加了3倍。标准体外受精后没有发现尿道下裂的额外风险。对这些发现的各种解释进行了讨论。据推测，消化道闭锁的额外风险，就像体外受精后同卵双胞胎的额外风险一样，是体外受精手术的直接后果。胞浆内注射后尿道下裂的额外风险可能与具有遗传背景的父亲低生育能力有关。与体外受精相关的先天性畸形的绝对风险很小。
The presence of congenital malformations in infants born after IVF was studied from a register consisting of practically all infants born in Sweden after IVF, 1982-1997 (n = 9111). A further 64 infants were studied using only medical records. It is a nation-wide study and has a population-based control group (n = 1 690 577) and relevant potential confounders have been taken into account. There was an excess of congenital malformations registered in the Medical Birth Registry (n = 516, odds ratio = 1.47) but this excess disappeared when confounders were taken into consideration: year of birth, maternal age, parity, and period of unwanted childlessness (odds ratio = 0.89). For some specific conditions, an similar to3-fold excess risk was seen neural tube defects, alimentary atresia, omphalocele, and hypospadias (after intracytoplasmatic sperm injection). No excess risk for hypospadias was seen after standard IVF. Various explanations for these findings are discussed. It is postulated that the excess risk for alimentary atresia, like the excess risk for monozygotic twinning after IVF, is a direct consequence of the IVF procedure. The excess risk for hypospadias after ICSI may be related to paternal subfertility with a genetic background. The absolute risk for a congenital malformation in association with IVF is small.