辅助生殖技术助孕后单胎妊娠早产风险的Meta分析  

Meta analysis of the risk of preterm birth in singleton pregnancy after assisted reproductive technology

作　　者：朱婷婷 王腾飞 吴慧婷 段鹏 周宇涵 Zhu Tingting;Wang Tengfei;Wu Huiting;Duan Peng;Zhou Yuhan(Department of Obstetrics and Gynaecology,Xiangyang No.1 People's Hospital,Hubei University of Medicine,Xiangyang Hubei 441000;The Fourth Clinical College,Hubei University of Medicine,Shiyan Hubei 442200,P.R.China)

机构地区：[1]湖北医药学院附属襄阳市第一人民医院妇产科,湖北襄阳441000 [2]湖北医药学院第四临床学院,湖北十堰442200

出　　处：《中国计划生育和妇产科》2023年第9期86-91,共6页Chinese Journal of Family Planning & Gynecotokology

基　　金：湖北省重点研发计划项目(项目编号:2022BCE021);襄阳市科技局重点项目(项目编号:2021YL29);湖北省“323”攻坚行动襄阳市第一人民医院重点专项科研基金(项目编号:XYY2022-323)。

摘　　要：目的系统评价辅助生殖技术(assisted reproductive technology,ART)助孕后单胎妊娠与早产发生风险的相关性。方法计算机检索PubMed、Web of Science、Medline、EMbase、CBM、VIP和CNKI数据库,检索时限为自建库至2022年5月1日发表的关于评价ART助孕后单胎妊娠早产发生风险的队列研究文献,由两名独立研究者按照纳入和排除标准进行文献的筛选和资料的提取、偏移评估。使用Stata SE 10.0软件进行Meta分析。结果最终纳入12篇队列研究,英文文献10篇,涵盖10个国家和地区;ART助孕和自然受孕的单胎妊娠孕妇例数分别是21060和671687例,Meta分析结果显示,ART助孕后单胎妊娠早产发生风险高于自然受孕单胎妊娠[RR=1.56,95%CI(1.27-1.91),P<0.001]。按ART类型、效应指标、地区、ART样本量、发表时间等行亚组分析,结果均显示ART助孕可增加单胎妊娠早产风险。结论ART助孕后单胎妊娠早产发生风险高于自然受孕单胎妊娠,ART助孕后的妊娠孕妇应积极做好产前保健工作以避免早产发生。Objective To systematically review the correlation between single pregnancy after assisted reproductive technology(ART)and the risk of preterm birth.Method Retrieved the cohort studies that meet the inclusion criteria in the PubMed,Web of Science,Medline,EMbase,CBM,VIP,and CNKI databases from the establishment of the database to May 2022.These cohort research literature was related to the risk of single pregnancy after ART and preterm birth.Literature screening,data extraction and bias assessment were conducted by two independent investigators according to pre-set inclusion and exclusion criteria.Meta-analysis was performed by using Stata-SE 10.0 software.Results A total of 12 cohort studies were included,10 in English,covering 10 countries and regions.The extracted data included a total of 21060 single pregnancies after ART conception,and 671687 cases of singleton pregnancies after natural conception.Meta-analysis showed that the risk of preterm birth in singleton pregnancy after ART was higher than that in natural conception singleton pregnancy[RR=1.56,95%CI(1.27-1.91),P<0.001].Subgroup analysis according to ART type,effect index,region,ART sample size and publication time also showed that single pregnancy after ART might increase the risk of preterm birth.Conclusion Singleton pregnancies after ART have higher risk of preterm birth than naturally conceived singleton pregnancies.Therefore,the pregnant women after ART should make good antenatal care work and try to avoid the occurrence of preterm birth.

关 键 词：辅助生殖技术 单胎妊娠 早产 队列研究 META分析 

分 类 号：R714.8[医药卫生—妇产科学]