Multiple pregnancies achieved with IVF/ICSI and risk of specific congenital malformations: a meta-analysis of cohort studies

REPRODUCTIVE BIOMEDICINE ONLINE

卷:36

Review

Zheng, Zan¹  Chen, Letao¹  Yang, Tubao¹  Yu, Hong²  Wang, Hua²  Qin, Jiabi¹ 

[1] Cent South Univ, Xiangya Sch Publ Hlth, Dept Epidemiol & Hlth Stat, Reprod Epidemiol, Changsha, Hunan, Peoples R China

[2] Hunan Prov Maternal & Child Hlth Hosp, Reprod Ctr, Changsha, Hunan, Peoples R China

关键词: Congenital malformations;    Intracytoplasmic sperm injection;    IVF;    Meta-analysis;    Multiple births;   

DOI  :  10.1016/j.rbmo.2018.01.009

来源: Elsevier

【 摘 要 】

Studies comparing risk of specific congenital malformations (CM) between multiple pregnancies resulting from IVF/intracytoplasmic sperm injection (ICSI) and those conceived naturally report conflicting results; furthermore, there is a lack of a complete overview. This meta-analysis aimed to address which types of CM are increased in IVF/ICSI multiple pregnancies compared with those conceived naturally. All studies testing the association between IVF/ICSI multiple pregnancies and specific CM identified in various databases were considered. The literature search yielded 856 records, of which 21 cohort studies were included for analysis. Overall, multiple pregnancies achieved with IVF/ICSI experienced a significantly higher risk of chromosomal defects (relative risk [RR] = 1.36; 95% confidence interval [CI]: 1.04-1.77), urogenital (RR = 1.18; 95% CI: 1.03-1.36) and circulatory (RR = 1.22; 95% CI: 1.01-1.47) system malformations. However, the remaining specific CM, such as cleft lip and/or palate, eye, ear, face and neck, respiratory, musculoskeletal, nervous and digestive system malformations, were similar in the two groups. No substantial heterogeneity was observed for most outcomes except for digestive (P = 0.094; I-2 = 38.3%) and circulatory (P = 0.070; I-2 = 35.2%) system malformations. These findings provide additional information on risks of IVF/ICSI for use when counselling patients. (c) 2018 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

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