Assessment of Birth Defects and Cancer Risk in Children Conceived via In Vitro Fertilization in the US.
Assessment of Birth Defects and Cancer Risk in Children Conceived via In Vitro Fertilization in the US.
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DOI：
10.1001/jamanetworkopen.2020.22927
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发表时间：
2020-10-01
影响因子：
13.8
通讯作者：
Lupo PJ
中科院分区：
文献类型：
--
作者：
Luke B;Brown MB;Nichols HB;Schymura MJ;Browne ML;Fisher SC;Forestieri NE;Rao C;Yazdy MM;Gershman ST;Ethen MK;Canfield MA;Williams M;Wantman E;Oehninger S;Doody KJ;Eisenberg ML;Baker VL;Lupo PJ
通过体外受精怀孕的儿童的出生缺陷和儿童癌症的发生率与自然受孕的儿童不同吗？在这项以人群为基础的队列研究中，来自4个州的1053 415名儿童发现，出生缺陷的存在和出生缺陷的数量与儿童患癌症的风险增加有关。通过体外受精受孕的儿童的风险比自然受孕的儿童高2倍。在这项研究中，通过体外受精受孕的儿童患癌症的风险比自然受孕的儿童更高，因为存在出生缺陷；值得进一步研究。有先天缺陷的儿童患癌症的风险更大，但这种关联尚未在体外受精（IVF）受孕的儿童中得到评估。评估通过体外受精受孕的儿童与自然受孕的儿童相比，出生缺陷与癌症之间的关联是否更大。这项来自马萨诸塞州、纽约州、北卡罗来纳州和德克萨斯州的活产、出生缺陷和癌症队列研究包括2004-2016年在马萨诸塞州和北卡罗来纳州、2004-2015年在纽约州、2004-2013年在德克萨斯州通过体外受精（使用自体卵母细胞和新鲜胚胎）生育的1 000 639名儿童和52 776名儿童。儿童平均随访5.7年（6 008 985总暴露人年）。数据分析时间为2020年4月1日至8月31日。在研究期间生下活产单胎的州居民的体外受精受孕。出生缺陷诊断记录在州范围内的登记处。州癌症登记处记录的癌症诊断。使用Cox比例风险回归模型分别估计生育组和体外受精组出生缺陷-癌症关联的风险比（hr）和95% ci。生育组共有1 000 639名儿童（51.3%为男孩，69.7%为白人，2009-2012年间出生的儿童占38.3%），体外受精组有52 776名儿童（51.3%为男孩，81.3%为白人，2009-2012年间出生的儿童占39.6%）。与没有出生缺陷的儿童相比，生育组有重大出生缺陷的儿童患癌症的风险更高（风险比[HR]， 3.15; 95% CI, 2.40-4.14），体外受精组（HR, 6.90; 95% CI, 3.73-12.74）。在有重大非染色体缺陷的儿童中，生育组儿童的癌症风险比为2.07 (95% CI, 1.47-2.91)，体外受精组儿童的癌症风险比为4.04 （95% CI, 1.86-8.77）。有染色体缺陷的儿童患癌风险比（HR）在生育组为15.45 (95% CI, 10.00-23.86)，在体外受精组为38.91 （95% CI, 15.56-97.33）。这项研究发现，在有先天缺陷的儿童中，通过体外受精受孕的儿童患癌症的风险高于自然受孕的儿童。这项以人群为基础的队列研究评估了美国4个州通过体外受精和自然受孕的儿童出生缺陷和癌症风险之间的关系。
Is the incidence of birth defects and childhood cancer among children conceived via in vitro fertilization different from that among children conceived naturally? In this population-based cohort study of 1 053 415 children in 4 states, the presence of a birth defect and the number of birth defects were associated with an increased risk of childhood cancer. The increased risk was 2-fold higher for children conceived via in vitro fertilization than for children conceived naturally. In this study, cancer risk increased in the presence of birth defects at a higher rate in children conceived via in vitro fertilization than in children conceived naturally; further study is warranted. Children with birth defects have a greater risk of developing cancer, but this association has not yet been evaluated in children conceived with in vitro fertilization (IVF). To assess whether the association between birth defects and cancer is greater in children conceived via IVF compared with children conceived naturally. This cohort study of live births, birth defects, and cancer from Massachusetts, New York, North Carolina, and Texas included 1 000 639 children born to fertile women and 52 776 children conceived via IVF (using autologous oocytes and fresh embryos) during 2004-2016 in Massachusetts and North Carolina, 2004-2015 in New York, and 2004-2013 in Texas. Children were followed up for an average of 5.7 years (6 008 985 total person-years of exposure). Data analysis was conducted from April 1 to August 31, 2020. Conception by IVF for state residents who gave birth to liveborn singletons during the study period. Birth defect diagnoses recorded by statewide registries. Cancer diagnosis as recorded by state cancer registries. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% CIs for birth defect–cancer associations separately in fertile and IVF groups. A total of 1 000 639 children (51.3% boys; 69.7% White; and 38.3% born between 2009-2012) were in the fertile group and 52 776 were in the IVF group (51.3% boys; 81.3% White; and 39.6% born between 2009-2012). Compared with children without birth defects, cancer risks were higher among children with a major birth defect in the fertile group (hazard ratio [HR], 3.15; 95% CI, 2.40-4.14) and IVF group (HR, 6.90; 95% CI, 3.73-12.74). The HR of cancer among children with a major nonchromosomal defect was 2.07 (95% CI, 1.47-2.91) among children in the fertile group and 4.04 (95% CI, 1.86-8.77) among children in the IVF group. The HR of cancer among children with a chromosomal defect was 15.45 (95% CI, 10.00-23.86) in the fertile group and 38.91 (95% CI, 15.56-97.33) in the IVF group. This study found that among children with birth defects, those conceived via IVF were at greater risk of developing cancer compared with children conceived naturally. This population-based cohort study assesses the association between birth defects and cancer risk among children conceived via in vitro fertilization vs children conceived naturally in 4 US states.
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影响因子：
6.1
作者：
Henningsen, A. A.;Gissler, M.;Lidegaard, O.
通讯作者：
Lidegaard, O.
影响因子：
3.5
作者：
Weksberg, R;Smith, AC;Sadowski, P
通讯作者：
Sadowski, P
影响因子：
28.4
作者：
Lupo, Philip J.;Schraw, Jeremy M.;Plon, Sharon E.
通讯作者：
Plon, Sharon E.
影响因子：
6.2
作者：
Steliarova-Foucher, E;Stiller, C;Kaatsch, P
通讯作者：
Kaatsch, P
影响因子：
30.8
作者：
Jin SC;Homsy J;Zaidi S;Lu Q;Morton S;DePalma SR;Zeng X;Qi H;Chang W;Sierant MC;Hung WC;Haider S;Zhang J;Knight J;Bjornson RD;Castaldi C;Tikhonoa IR;Bilguvar K;Mane SM;Sanders SJ;Mital S;Russell MW;Gaynor JW;Deanfield J;Giardini A;Porter GA Jr;Srivastava D;Lo CW;Shen Y;Watkins WS;Yandell M;Yost HJ;Tristani-Firouzi M;Newburger JW;Roberts AE;Kim R;Zhao H;Kaltman JR;Goldmuntz E;Chung WK;Seidman JG;Gelb BD;Seidman CE;Lifton RP;Brueckner M
通讯作者：
Brueckner M