辅助生殖技术与儿童注意缺陷多动障碍相关性的Meta分析  

Association of assisted reproductive technology with attention deficit hyperactivity disorder in children:A Meta-analysis

作　　者：孙费敏 李梦琦 夏泽源 熊忠贵[2] SUN Feimin;LI Mengqi;XIA Zeyuan;XIONG Zhonggui(School of Medicine,Wuhan University of Science and Technology,Wuhan,Hubei 430065,China;Department of Child Health,Maternal and Child Health Hospital of Hubei Province,Wuhan,Hubei 430070,China)

机构地区：[1]武汉科技大学医学部医学院,湖北武汉430065 [2]湖北省妇幼保健院儿童保健科,湖北武汉430070

出　　处：《中国优生与遗传杂志》2024年第4期715-721,共7页Chinese Journal of Birth Health & Heredity

摘　　要：目的系统评价辅助生殖技术(ART)与儿童注意缺陷多动障碍(ADHD)的相关性。方法检索PubMed、Web ofScience、Embase和Cochrane数据库并查阅参考文献,双人筛选并提取效应值,使用Stata17.0定量合成,以评估ART与ADHD的相关性。结果本研究纳入9项队列研究的10个队列,涉及204480名ART儿童。与非ART儿童相比,ART儿童发生ADHD的风险比(HR)增加,差异有统计学意义(HR=1.06,95%CI1.03~1.10,P<0.001);相对危险度(RR)也增加,但差异无统计学意义(RR=1.15,95%CI 0.79~1.69,P=0.460)。在单胎中,ART与儿童ADHD呈显著性正相关(HR=1.08,95%CI 1.03~1.14,P=0.001);在多胎中,ART与儿童ADHD无显著相关性(HR=1.01,95%CI0.88~1.16,P=0.879)。亚组(将效应值为HR的6项研究纳入HR组、效应值为RR的3项研究纳入RR组)分析结果显示,HR组来自北美洲的研究中ART与儿童ADHD相关性更强;HR组研究中控制性别时ART与儿童ADHD关联更强,RR组研究按不同亚组分类时ART与儿童ADHD均无显著关联性。结论由于HR组研究主要为大型人群研究且混杂因素的控制更为全面,其证据质量高于RR组,所以ART与儿童ADHD之间可能存在微弱的正相关。Objective To determine the association of assisted reproductive technology(ART)with attention deficit hyperactivity disorder(ADHD)in children via systematic evaluation.Methods Four databases,PubMed,Web of Science,Embase and Cochrane were searched,and references were reviewed.The literature was screened and effect sizes were extracted in duplicate to quantitatively synthesize the relevance of ART to ADHD.Results This study includes 10 cohorts from 9cohort studies,comprising 204480 children born from ART.The results showed that children conceived by ART had a statistically significant increased hazard ratio(HR)for ADHD(HR=1.06,95%CI 1.03-1.10,P<0.001)and a suggestive but not statistically significant increased relative risk(RR)(RR=1.15,95%CI 0.79-1.69,P=0.460)compared with children not conceived by ART.The study found a significant positive association between ART and ADHD in children who were singletons(HR=1.08,95%CI 1.03-1.14,P=0.001).However,no significant association was found between ART and ADHD in children who were multiples(HR=1.01,95%CI 0.88-1.16,P=0.879).Subgroup(The HR group included six studies with an effect size of HR,and the RR group included three studies with an effect size of RR)analyses showed that ART was more strongly associated with childhood ADHD in studies conducted in North America in the HR group,and also more strongly associated with childhood ADHD in studies conducted in the HR group when controlling for sex;none of studies conducted by the RR group found a significant association between ART and childhood ADHD when categorized by different subgroups.Conclusion The evidence quality was higher in the HR group compared to the RR group due to the inclusion of large population studies with more comprehensive control for confounders.Consequently,there appears to be a weak positive association between ART and ADHD in children.

关 键 词：儿童 辅助生殖技术 注意缺陷多动障碍 META分析 

分 类 号：R749.94[医药卫生—神经病学与精神病学]