Cerebral palsy in children born after assisted reproductive technology:a meta-analysis

• 作 者: Fang-Fang Wang Tao Yu Xiao-Lu Chen Rong Luo De-Zhi Mu
• 机 构: Department of Pediatrics,The First Affiliated Hospital of Zhengzhou University,Zhengzhou,China;Depar
• 出 处: 世界儿科杂志（英文版）
• 发表日期: 2021年4期
• 关键词: Assisted reproductive technology Cerebral palsy Meta-analysis

Background Several studies have assessed the association between cerebral palsy (CP) and assisted reproductive technology(ART),but the results remain controversial.We conducted a meta-analysis to evaluate the risk of CP after ART compared with natural conceptions and to examine CP risk separately in ART singletons,multiples and preterm births.Methods Web-based databases (PubMed,Embase,the Cochrane Library,and Web of Science) were searched until November 22,2020.Studies which compare CP rates after ART with natural conceptions were included.The Newcastle-Ottawa Scale was used to assess the quality of the included studies.Effect estimates were extracted and combined using the fixed-effects or random-effects model depending on the heterogeneity test.Results There were nine studies included in the meta-analysis.The included studies were of moderate or high quality.A significantly higher risk of CP[odds ratio (OR) =2.17,95％ confidence interval (CI) 1.72-2.74]was found in ART children(n =89,214) compared with naturally conceived children (n =4,160,745).The significantly higher risk decreased when data were restricted to singletons (OR =1.36,95％ CI 1.16-1.59) and disappeared when data were restricted to multiples(OR =1.05,95％ CI 0.86-1.29) or preterm births (OR =1.53,95％ CI 0.66-3.56).Subgroup and sensitivity analyses indicated that the overall results were robust.Conclusions The risk of CP is increased more than two-fold after ART.This increased risk is largely due to increased rates of multiple birth and preterm delivery in ART children.