本文已被：浏览 354次 下载 1615次
投稿时间：2022-09-17 网络发布日期：2023-05-20
投稿时间：2022-09-17 网络发布日期：2023-05-20
中文摘要: 目的 系统评价辅助生殖技术（ART）助孕与其子代自闭症发生的相关性。方法 计算机检索PubMed、Web of Science、CBM、VIP和CNKI数据库,搜集自建库至2022年4月1日发表的有关ART子代自闭症的队列研究。由4名研究者独立筛选文献,提取资料并使用纽卡斯尔-渥太华量表（NOS）评价文献质量后,采用Stata 15.1软件进行Meta分析。结果 最终纳入8篇文献,包括335507例ART子代及14233258例自然受孕（NC）子代进行Meta分析。敏感性分析剔除1篇异质性较大的研究后,结果显示与NC子代相比,ART子代自闭症发生率显著增加［RR=1.06,95%CI（1.01, 1.11）, P<0.05］。亚组分析结果显示,当数据来源于欧美［RR=1.06, 95%CI（1.01, 1.11）,P=0.014］,NOS评分7~9分［RR=1.06, 95%CI（1.01, 1.11）, P=0.022］,ART样本量＞10000［RR=1.06, 95%CI（1.01, 1.11）, P=0.016］,校正因子个数大于5［RR=1.06, 95%CI（1.01, 1.11）, P=0.014］以及控制模型中母亲精神病史［RR=1.06, 95%CI（1.01, 1.11）, P=0.022］,ART助孕后的子代自闭症风险高于NC子代。结论 ART可能会增加子代自闭症的发生风险,但尚需更多设计严格的队列研究以增加证据的强度。
Abstract:Objective To systematiclly evaluate the relationship between assisted reproductive technology（ART） and autism spectrum disorders（ASD） in their offspring. Methods Systematic searches of PubMed, Web of Science, CBM, VIP, and CNKI databases were conducted to collect the cohort studies on ASD in ART progeny published from database establishment to April 1, 2022. After four independent reviewers screened the literature, extracted the data and assessed their quality with Newcastle-Ottawa scale（NOS）, a Meta-analysis was performed using Stata 15.1 software. Results Finally, 8 articles were included to assess the risk of ASD in 335507 offspring after ART（ART group） and 14233258 offspring of natural conception（NC group）. After excluding one study with greater heterogeneity by sensitivity analysis,the incidence of child with ASD in ART group was significantly higher than that in NC group（RR=1.06, 95%CI1.01-1.11, P<0.05）. The stratified analysis showed that the risk of ASD in ART offspring was higher than that in NC offspring based on the subgroup analysis on the data from Europe and the United States（RR=1.06, 95%CI 1.01-1.11, P=0.014）, Newcastle Ottawa scale（NOS） score 7-9（RR=1.06, 95%CI 1.01-1.11, P=0.022）, ART sample size of more than 10000 participants（RR=1.06, 95%CI 1.01-1.11, P=0.016）, correction factors of more than 5（RR=1.06, 95%CI 1.01-1.11, P=0.014） and corrected maternal psychiatric morbidity（RR=1.06, 95%CI 1.01-1.11, P=0.022）. ConclusionsCurrent evidence suggests that ART may increase the risk of autism in offspring, but more rigorous cohort studies need to be designed to increase the strength of the evidence.
keywords: Assisted reproductive technology Offspring Autism spectrum disorders Cohort study Meta-analysis
文章编号： 中图分类号：R714.8 R749.94 文献标志码：B
基金项目:国家自然科学基金（81901567）；湖北省“323”攻坚行动襄阳市第一人民医院重点专项（XYY2022-323）
引用文本：
肖巧红,徐梦瑶,史晓煊,等.辅助生殖技术对子代自闭症影响的Meta分析[J].中国临床研究,2023,36(5):715-720.
肖巧红,徐梦瑶,史晓煊,等.辅助生殖技术对子代自闭症影响的Meta分析[J].中国临床研究,2023,36(5):715-720.