Jia-Bi Qin1,2, Xiao-Qi Sheng3, Di Wu4, Shi-You Gao5, Yi-Ping You6, Tu-Bao Yang7, Hua Wang8. 1. Information Management Division, Hunan Provincial Maternal and Child Health Care Hospital, 53 Xiangchun Road, Changsha, 410008, Hunan, China. qinjiabi123@163.com. 2. Division of Medical Genetics, Hunan Provincial Maternal and Child Health Care Hospital, 53 Xiangchun Road, Changsha, 410008, Hunan, China. qinjiabi123@163.com. 3. Division of Medical Genetics, Hunan Provincial Maternal and Child Health Care Hospital, 53 Xiangchun Road, Changsha, 410008, Hunan, China. 4. Enrollment and Employment Office, Hunan University of Traditional Chinese Medicine, Changsha, Hunan, China. 5. Reproductive Medicine Center, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China. 6. Maternity Department, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China. 7. Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan, China. 8. Division of Medical Genetics, Hunan Provincial Maternal and Child Health Care Hospital, 53 Xiangchun Road, Changsha, 410008, Hunan, China. wangh1234@hotmail.com.
Abstract
PURPOSE: The worldwide prevalence of adverse pregnancy outcomes (APOs) in singleton pregnancies after in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) is suggested to vary; however, a complete overview is missing. The aim of this review is to estimate the worldwide prevalence of APOs associated with IVF/ICSI singleton pregnancies. METHODS: PubMed, Google Scholar, Cochrane Libraries, and Chinese databases were searched for studies assessing APOs among IVF/ICSI singleton births through March 2016. The prevalence estimates were summarized and analyzed by meta-analysis. RESULTS: Fifty-two cohort studies, with 181,741 IVF/ICSI singleton births and 4,636,508 spontaneously conceived singleton births, were selected for analysis. Among IVF/ICSI singleton pregnancies, pooled estimates were 10.9% [95% confidence interval (CI) 10.0-11.8] for preterm birth, 2.4% (95% CI 1.9-3.0) for very preterm birth, 8.7% (95% CI 7.4-10.2) for low birth weight, 2.0% (95% CI 1.5-2.6) for very low birth weight, 7.1% (95% CI 5.5-9.2) for small for gestational age, 1.1% (95% CI 0.9-1.3) for perinatal mortality, and 5.7% (95% CI 4.7-6.9) for congenital malformations. The IVF/ICSI singleton pregnancies have higher prevalence of APOs compared with those conceived naturally (all P = 0.000). Significant differences in different continents, countries, income groups, and type of assisted conception were found. CONCLUSIONS: The IVF/ICSI singleton pregnancies are at a higher prevalence of adverse perinatal outcomes compared with those conceived naturally. Important geographical differences were found. Yet, population-wide prospective APO registries covering the entire world population for IVF/ICSI pregnancies are needed to determine the exact perinatal prevalence.
PURPOSE: The worldwide prevalence of adverse pregnancy outcomes (APOs) in singleton pregnancies after in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) is suggested to vary; however, a complete overview is missing. The aim of this review is to estimate the worldwide prevalence of APOs associated with IVF/ICSI singleton pregnancies. METHODS: PubMed, Google Scholar, Cochrane Libraries, and Chinese databases were searched for studies assessing APOs among IVF/ICSI singleton births through March 2016. The prevalence estimates were summarized and analyzed by meta-analysis. RESULTS: Fifty-two cohort studies, with 181,741 IVF/ICSI singleton births and 4,636,508 spontaneously conceived singleton births, were selected for analysis. Among IVF/ICSI singleton pregnancies, pooled estimates were 10.9% [95% confidence interval (CI) 10.0-11.8] for preterm birth, 2.4% (95% CI 1.9-3.0) for very preterm birth, 8.7% (95% CI 7.4-10.2) for low birth weight, 2.0% (95% CI 1.5-2.6) for very low birth weight, 7.1% (95% CI 5.5-9.2) for small for gestational age, 1.1% (95% CI 0.9-1.3) for perinatal mortality, and 5.7% (95% CI 4.7-6.9) for congenital malformations. The IVF/ICSI singleton pregnancies have higher prevalence of APOs compared with those conceived naturally (all P = 0.000). Significant differences in different continents, countries, income groups, and type of assisted conception were found. CONCLUSIONS: The IVF/ICSI singleton pregnancies are at a higher prevalence of adverse perinatal outcomes compared with those conceived naturally. Important geographical differences were found. Yet, population-wide prospective APO registries covering the entire world population for IVF/ICSI pregnancies are needed to determine the exact perinatal prevalence.
Authors: Tom P Fleming; Adam J Watkins; Miguel A Velazquez; John C Mathers; Andrew M Prentice; Judith Stephenson; Mary Barker; Richard Saffery; Chittaranjan S Yajnik; Judith J Eckert; Mark A Hanson; Terrence Forrester; Peter D Gluckman; Keith M Godfrey Journal: Lancet Date: 2018-04-16 Impact factor: 79.321