目的:ART后出生的儿童患1型糖尿病(DM1)的风险是否高于未接受ART的儿童?
结论:接受和未接受ART的儿童患DM1的风险相似,根据生育治疗方法,风险没有明显差异。
背景:ART与不良围产期结局的高风险相关,风险取决于ART的方法。健康与疾病理论的发展起源提出,产前压力会引起内分泌过程的变化,从而影响以后的健康。
■进行了一项基于北欧注册的队列研究,包括在丹麦出生的所有儿童(1994-2014年出生),芬兰(1990-2014),挪威(1984-2015)。该研究包括在ART后出生的76.184例出生的单胎和在没有ART的情况下出生的4.403.419例。ART和非ART组的中位随访时间分别为8.3年和13.7年,分别。
方法:队列,由北欧辅助生殖技术和安全委员会(CoNARTaS)发起,是通过将医疗出生登记处的国家登记数据和北欧国家的国家患者登记处联系起来建立的。我们对1984-1990年、1991-1995年、1996-2000年、2001-2005年、2006-2010年和2011-2015年的出生年份进行了多变量逻辑回归分析,同时调整了每个间隔内的出生年份,孩子的性别,奇偶校验,产妇年龄,母体糖尿病,和孕妇在怀孕期间吸烟是潜在的混杂因素。
结果:随访期间,在ART后出生的259例(3.4‰)儿童被诊断为DM1,而没有ART出生的22.209例(5.0‰)就是这种情况,对应于0.98的调整后比值比(95%CI:0.861.11)。在不同的出生年份间隔内,两组的DM1风险没有显著差异,除了2011-2015年出生的最年轻儿童队列外,ART与DM1的高风险相关.当比较IVF与ICSI或新鲜与冷冻胚胎移植后出生的儿童时,我们发现DM1的风险没有显着差异。但每组病例很少。
结论:该研究的主要局限性是随访时间相对较短。DM1的发病率在10-14岁期间达到峰值,因此,更长的随访将有利于所有分析,特别是,分组分析。
结论:总体而言,我们的研究结果令人放心,特别是考虑到通过ART出生的儿童数量的增加以及全球DM1发病率的增加.
背景:这项北欧注册研究得到了北欧试验联盟/NORDFORSK和Rigshospitalets研究基金会的支持。资金来源在研究设计中没有作用;在收集中,分析,和数据的解释;在撰写报告时;以及提交该文章发表的决定。没有任何作者对这项研究有任何利益冲突。
背景:ISRCTN11780826。
OBJECTIVE: Do children born after ART have a higher risk of developing Type 1 diabetes (DM1) than children conceived without ART?
CONCLUSIONS: The risk of DM1 was similar for children conceived with and without ART, and there were no clear differences in risk according to method of fertility treatment.
BACKGROUND: ART is associated with a higher risk of adverse perinatal outcomes, and the risk depends on the method of ART. The Developmental Origins of Health and Disease theory proposes that prenatal stress can provoke changes in endocrine processes which impact health later in life.
UNASSIGNED: A Nordic register-based cohort study was carried out, including all children born in Denmark (birth years 1994-2014), Finland (1990-2014), and Norway (1984-2015). The study included 76 184 liveborn singletons born after ART and 4 403 419 born without ART. Median follow-up was 8.3 and 13.7 years in the ART and non-ART group, respectively.
METHODS: The cohort, initiated by the Committee of Nordic Assisted Reproductive Technology and Safety (CoNARTaS), was established by linking national registry data from the medical birth registries and national patient registries available in the Nordic countries. We performed multivariable logistic regression analyses for the birth year intervals 1984-1990, 1991-1995, 1996-2000, 2001-2005, 2006-2010, and 2011-2015, while adjusting for year of birth within each interval, sex of the child, parity, maternal age, maternal diabetes, and maternal smoking during pregnancy as potential confounders.
RESULTS: During follow-up, 259 (3.4‰) children born after ART were diagnosed with DM1, while this was the case for 22 209 (5.0‰) born without ART, corresponding to an adjusted odds ratio of 0.98 (95% CI: 0.861.11). Within the different birth year intervals, no significant difference in risk of DM1 between the two groups was found, except for the youngest cohort of children born 2011-2015 where ART was associated with a higher risk of DM1. We found no significant differences in risk of DM1 when comparing children born after IVF versus ICSI or fresh versus frozen embryo transfer, but with only few cases in each group.
CONCLUSIONS: The main limitation of the study is the relatively short follow-up time. The incidence rate of DM1 peaks during ages 10-14 years, hence a longer follow-up would benefit all analyses and, in particular, the subgroup analyses.
CONCLUSIONS: Overall, our findings are reassuring especially considering the concomitantly increasing number of children born from ART and the increasing incidence of DM1 globally.
BACKGROUND: This Nordic registry study has been supported by the Nordic Trial Alliance/NORDFORSK and Rigshospitalets Research Foundation. The funding sources had no role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. None of the authors has any conflicts of interest to declare regarding this study.
BACKGROUND: ISRCTN11780826.