不同辅助生殖技术及子代性别与出生缺陷的关系

Relationship between different assisted reproductive technology and offspring gender and birth defects

目的探讨不同辅助生殖技术(ART)及子代性别与出生缺陷的关系。方法选择2017年1月至2021年12月于郑州大学第一附属医院生殖医学中心接受ART助孕治疗后获得的围产儿为研究对象。本研究共纳入34626例围产儿,根据父母采用的ART将围产儿分为体外受精(IVF)组(n=12449)、卵胞浆内单精子注射技术(ICSI)组(n=4680)、冻融胚胎移植(FET)组(n=13888)和夫精人工授精(AIH)/供精人工授精(AID)组(n=3609);另根据性别,将围产儿分为男婴组(n=18018)和女婴组(n=16608)。通过电话或门诊问诊的方式对围产儿出生情况进行随访。统计出生缺陷情况及出生缺陷类型,并计算出生缺陷发生率。结果本研究纳入的34626例围产儿中,出生缺陷患儿295例,总出生缺陷率为85.20/万。2017~2021年每年出生缺陷率分别为83.27/万(55/6605)、95.01/万(64/6736)、92.68/万(69/7445)、87.50/万(59/6743)、67.63/万(48/7097);2017~2021年每年出生缺陷率比较差异无统计学意义(χ^(2)=3.925,P>0.05)。2017~2021年,IVF组、ICSI组、FET组、AIH/AID组出生缺陷发生率比较差异均无统计学意义(χ^(2)=3.666、2.791、2.071、3.005、2.282,P>0.05)。295例出生缺陷儿中,构成比位居前3位的出生缺陷类型依次为心血管循环系统(27.80%)、骨骼肌肉系统(15.25%)、胃肠消化系统(14.92%);IVF组、ICSI组、FET组、AIH/AID组的出生缺陷类型构成比最高的均为心血管循环系统畸形。2017~2021年,男婴组与女婴组的出生缺陷发生率比较差异均无统计学意义(χ^(2)=0.842、0.228、0.087、0.016、1.180,P>0.05)。男婴组和女婴组中构成比位居前3位的出生缺陷类型均为心血管循环系统、胃肠道消化系统、骨骼肌肉系统。结论采用不同ART助孕出生的子代中最常见的出生缺陷类型为心血管循环系统,不同ART及子代性别不会影响子代出生缺陷发生率。

Objective To investigate the relationship between different assisted reproductive technology(ART)and the gender of offspring and birth defects.Methods Perinatal infants who received ART assisted pregnancy treatment at the Reproductive Medicine Center,the First Affiliated Hospital of Zhengzhou University from January 2017 to December 2021 were selected as the study subjects.A total of 34626 perinatal infants were included in this study.They were divided into the in vitro fertilization(IVF)group(n=12449),intracytoplasmic sperm injection technology(ICSI)group(n=4680),frozen thawed embryo transfer(FET)group(n=13888),and artificial insemination by husband(AIH)/artificial insemination by donor(AID)group(n=3609)based on the ART adopted by their parents;according to gender,the perinatal infants were divided into the male infant group(n=18018)and female infant group(n=16608).Perinatal infants were followed up by telephone or outpatient consultation.The situation and types of birth defects were recorded,and the incidence of birth defects was calculated.Results Among the 34626 perinatal infants included in this study,295 cases had birth defects,with a total birth defect rate of 85.20/10000.The birth defect rates from 2017 to 2021 were 83.27/10000(55/6605),95.01/10000(64/6736),92.68/10000(69/7445),87.50/10000(59/6743),and 67.63/10000(48/7097),respectively;there was no significant difference in birth defect rates among 2017 to 2021(χ^(2)=3.925,P>0.05).From 2017 to 2021,there was no significant difference in the incidence of birth defects among the IVF group,ICSI group,FET group and AIH/AID group(χ^(2)=3.666,2.791,2.071,3.005,2.282;P>0.05).Among the 295 cases of birth defects,the top three types of birth defects in terms of composition ratio were cardiovascular system(27.80%),skeletal muscle system(15.25%),and gastrointestinal digestive system(14.92%);the highest proportion of birth defect types in the IVF group,ICSI group,FET group and AIH/AID group was cardiovascular circulatory system abnormalities.From 2017 to 2021,there was no significant difference in the incidence of birth defects between the male infant group and female infant group(χ^(2)=0.842,0.228,0.087,0.016,1.180;P>0.05).The top three types of birth defects in the male infant group and female infant group were cardiovascular system,gastrointestinal digestive system,and skeletal muscle system.Conclusion The most common birth defect type among offspring born with different ART assisted pregnancies is the cardiovascular system,and different ART and offspring gender do not affect the incidence of birth defects in offspring.