The prevalence of major congenital malformations during two periods of time, 1986-1994 and 1995-2002 in newborns conceived by assisted reproduction technology
The prevalence of major congenital malformations during two periods of time, 1986-1994 and 1995-2002 in newborns conceived by assisted reproduction technology
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DOI：
10.1016/j.ejmg.2005.01.019
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发表时间：
2005-01-01
影响因子：
1.9
通讯作者：
Fisch, B
中科院分区：
文献类型：
--
作者：
Merlob, P;Sapir, O;Fisch, B
有证据表明，辅助生殖技术（ART）可能与先天性畸形、低出生体重和遗传印记疾病的风险增加有关。该研究的目的是确定1986-1994年通过标准体外受精（IVF）怀孕的新生儿和1995-2002年通过不同类型的ART程序怀孕的新生儿中主要畸形的发生率。从试管婴儿登记处和以色列出生缺陷监测系统收集了妊娠20周后出生的所有婴儿（活产、死产和终止妊娠）的数据，这些婴儿的胎儿体重至少为500g。对照组由同一时期在本中心出生的所有自然受孕婴儿（活产、死产和终止妊娠）组成。在第一阶段，共有31,007名婴儿在我们中心出生，其中278名是通过标准试管婴儿受孕的。体外受精婴儿中有26例出现严重畸形，患病率为9.35%，是普通人群（4.05%）的2.3倍。在第二个时期，出生了53,208名婴儿，其中1632名是通过抗逆转录病毒技术怀孕的。在147例ART婴儿中发现严重畸形，患病率为9.0%，比一般人群（5.18%）高出1.75倍。主要畸形ART患儿的临床特征分析显示，早产儿占70.3%，低出生体重儿占76.5%，双胞胎占58.6%，三胞胎占11.7%。ART治疗的使用在第二阶段增加了3.4倍。我们观察到了ART治疗的两个重要结果：在这两个时期，主要畸形的患病率增加，大约是一般人群的两倍；在ART治疗的主要畸形婴儿中，出现不良临床特征的频率很高。不孕夫妇应该得到充分的咨询，了解孩子有畸形或早产或低出生体重婴儿的真正风险。(c) 2004年Elsevier SAS。版权所有。
Evidence has emerged that assisted reproduction technology (ART) may be associated with an increased risk of congenital malformations, low birth weight, and genetic imprinting disorders. The aim of the study was to determine, the prevalence of major malformations in newborns conceived by standard in vitro fertilization (IVF) in 1986-1994 and newborns conceived by different types of ART procedures in 1995-2002. Data were collected from the IVF Registry and Israel Birth Defects Monitoring System for all infants (live births, stillbirths and terminations of pregnancy) delivered after 20 weeks' gestation who achieved a fetal weight of at least 500 g. The control groups consisted of all spontaneously conceived babies (live births, stillbirths and terminations of pregnancy) born in our center during the same time periods. During the first period, a total of 31,007 babies were born at our center, of whom 278 were conceived by standard IVF. Twenty-six of the IVF infants had major malformations, for a prevalence rate of 9.35%, which was 2.3-fold higher than that in the general population (4.05%). During the second period, 53,208 infants were born, of whom 1632 were conceived by ART. Major malformations were found in 147 ART infants, for a prevalence rate of 9.0%, which was 1.75-fold higher than in the general population (5.18%). Analysis of the clinical characteristics of the ART infants with major malformations showed that 70.3% were born preterm, 76.5% had low birth weight, 58.6 were twins, and 11.7% were triplets. The use of ART procedures increased by a factor of 3.4 in the second period. Two important outcomes of ART were observed: an increased prevalence of major malformations about double the general population in both periods, and a high frequency of adverse clinical characteristics among ART infants with major malformations. Infertile couples should be adequately counseled regarding the real risk of having a child with malformations or a preterm or low birth weight infant. (c) 2004 Elsevier SAS. All rights reserved.