选择性5-羟色胺再摄取抑制剂用于行体外受精联合胚胎移植术的抑郁症妇女妊娠安全性的系统评价

Pregnancy Safety of Selective 5-Serotonin Reuptake Inhibitor for Depression in Women Underwent in vitro Fertilization Combined with Embryo Transfer:A Systematic Evaluation

目的:系统评价选择性5-羟色胺再摄取抑制剂(SSRI)用于行体外受精联合胚胎移植术的抑郁症妇女的妊娠安全性,为临床提供循证参考。方法:计算机检索PubMed、EMBase、Cochrane图书馆、Medline、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊数据库和万方数据库,纳入SSRI(试验组)对比不接受药物或仅使用安慰剂(对照组)用于行体外受精联合胚胎移植术的抑郁症妇女的试验,提取资料并评价质量后,采用Rev Man 5.3统计软件进行Meta分析。结果:共纳入4项研究,合计2 122例患者。Meta分析结果显示,两组患者流产率[RR=0.90,95%CI(0.61,1.35),P=0.62]、受孕率[RR=1.03,95%CI(0.73,1.45),P=0.87]和胎儿出生率[RR=1.03,95%CI(0.65,1.63),P=0.91]比较,差异均无统计学意义。结论:SSRI用于行体外受精联合胚胎移植术的抑郁症妇女不会增加流产率,对受孕率和胎儿出生率亦无显著影响。

OBJECTIVE： To systematically review the pregnancy safety of selective 5-serotonin reuptake inhibitor （SSRI） for depression in women underwent in vitro fertilization （IVF） combined with embryo transfer, and to provide evidence-based refer-ence. METHODS： Retrieved from PubMed, EMBase, Cochrane Library, Medline, CBM, CJFD, VIP and Wanfang database, tri- als about SSRI （trial group） vs. no medicine or placebo alone （control group） for depression in women underwent IVF combined embryo transfer were collected. Meta-analysis was performed by using Rev Man 5.3 statistical software after data extraction and quality evaluation. RESULTS： A total of 4 studies were included, involving 2 122 patients. Results of Meta-analysis showed there was no statistical significance in miscarriage rate [RR----0.90, 95% CI（0.61, 1.35）,P=0.62], pregnancy rate [RR=I.03, 95% CI （0.73, 1.45）,P----0.87] or live birth rate [RR=1.03,95%CI（0.65, 1.63）,P=0.91] between 2 groups. CONCLUSIONS： For depres- sion in women underwent IVF combined with embryo transfer, SSRI do not increase miscarriage rate, decrease pregnancy rate and live birth rate and have no significant effect on the results of IVF combined with embryo transfer.