我国辅助生殖技术受孕与早产关联性及人群归因危险度的Meta分析

Meta-analysis of Association Between Assisted Reproductive Technology Conception and Preterm Birth and Population Attributable Risk in China

目的采用Meta分析方法探讨我国采用辅助生殖技术受孕与早产的相关性及人群归因危险度。方法通过检索国内4个数据库[中国生物医学数据库(SinoMed-CBM)、中国知网、万方数据平台、维普数据库]和国外3个数据库[PubMed、The Cochrane Library、Web of Science(WOS)],收集我国大陆地区2007年1月1日-2020年1月1日发表的孕妇早产相关危险因素的研究文献。应用STATA12.0统计软件进行荟萃分析。结果共纳入的12个研究,早产例数16759例,早产组中应用ART的585例,暴露率为3.52%;足月组121077例,足月组中应用辅助生殖技术的共660例,暴露率为0.55%;Meta分析显示,辅助生殖技术受孕与早产有相关性[OR=3.72,95%CI(2.46,5.61),P<0.001];综合人群归因危险度为2.57%。结论辅助生殖技术受孕与早产密切相关,我国辅助生殖技术的应用增加了胎儿早产的风险,应对采用辅助生殖技术受孕的孕产妇加强管理和干预,并监督其积极治疗,预防早产的发生。

Objective To explore the association between assisted reproductive technology and preterm birth and population attributable risk in China by Meta-analysis.Methods By searching four domestic databases[Chinese Biomedical Database(SinoMed-CBM),China Knowledge Network,Wanfang Data Platform,VIP Database]and three foreign databases[PubMed,The Cochrane Library,Web of Science(WOS)],the research literature on risk factors related to preterm birth in pregnant women published in China's Mainland from January 1,2007 to January 1,2020 was collected.STATA12.0 statistical software was used for meta-analysis.Results A total of 12 studies were included,16759 cases of preterm birth,585 cases of ART in preterm birth group,the exposure rate was 3.49%;there were 121077 cases in the full-term group and 660 cases in the full-term group using assisted reproductive technology,with an exposure rate of 0.55%.Meta-analysis showed that assisted reproductive technology was associated with preterm birth[=3.72,95%(2.46,5.61),<0.001].The comprehensive population attributable risk was 2.57%.Conclusion Assisted reproductive technology is associated with preterm birth.The application of ART in China has increased the risk of premature delivery,so it is necessary to strengthen the management and intervention of pregnant women conceived with assisted reproductive technology,and supervise their active treatment to prevent the occurrence of premature delivery.