Association of assisted reproductive technology and multiple pregnancies with the risks of birth defects and stillbirth: A retrospective cohort study

Yang, Min; Fan, Xiaobo; Wu, Jiang‐Nan; Wang, Jimei

doi:10.1038/s41598-018-26567-2

Cited by 31 publications

(34 citation statements)

References 41 publications

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“…To date, the impact of birth policy changes on women's reproductive decisions, delivery mode, pregnancy complications, pregnancy age, and birth outcomes has been reported [6][7][8][9][10][11]. An association between certain maternal characteristics and birth defects (BDs) has also been reported, such as maternal age, maternal parity, use of assisted reproductive technology, and diabetes mellitus [12][13][14][15]. However, few studies have conducted a comprehensive investigation of the epidemiology of BDs with respect to the birth policy changes in China.…”

Section: Introductionmentioning

confidence: 99%

Changes in maternal age and prevalence of congenital anomalies during the enactment of China's universal two-child policy (2013–2017) in Zhejiang Province, China: An observational study

et al. 2020

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Background China implemented a partial two-child policy (2013) followed by a universal two-child policy (2015), replacing the former one-child policy mandated by the government. The changes affect many aspects of China's population as well as maternal and infant health, but their potential impact on birth defects (BDs) remains unknown. In this study, we investigated the associations of these policy changes with BDs in Zhejiang Province, China. Methods and findings We used data from the BD surveillance system in Zhejiang Province, China, which covers 90 hospitals in 30 urban districts and rural counties, capturing one-third of the total births in this province. To fully consider the time interval between conception and delivery, we defined the one-child policy period as data from 2013 (births from October 2012 to September 2013), the partial two-child policy period as data from 2015 (births from October 2014 to September 2015), and the universal two-child policy period as data from 2017 (births from October 2016 to September 2017). Data from 2009 and 2011 were also used to show the changes in the proportion of births to women with advanced maternal age (35 years and older) prior to the policy changes. Main outcome measures were changes in the proportion of mothers with advanced maternal age, prevalence of BDs, rankings of BD subtypes by prevalence, prenatal diagnosis rate, and live birth rate of BDs over time. A total of 1,260,684 births (including live births, early fetal losses, stillbirths, and early neonatal deaths) were included in the analyses. Of these, 644,973 (51.16%) births were to women from urban

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Section: Introductionmentioning

confidence: 99%

Changes in maternal age and prevalence of congenital anomalies during the enactment of China's universal two-child policy (2013–2017) in Zhejiang Province, China: An observational study

et al. 2020

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“…We conducted a hospital-based retrospective study of pregnant women who received prenatal examinations at the hospital between April 2012 and August 2016 in Shanghai, China. Details of the design and methods have been described elsewhere [ 19 ]. Briefly, birth defect outcomes, including hypospadias, for infants reported in the Chinese Birth Defect Surveillance Network and in the Shanghai Perinatal Statistics Collection System were extracted and matched with hospital discharge reports for pregnant women that were compiled in the hospital electronic medical record system according to the unique identity card number of each mother.…”

Section: Methodsmentioning

confidence: 99%

“…Male hypospadias was diagnosed by clinicians according to the routine comprehensive physical examination for infants after delivery and was recorded in the medical information system [ 19 ]. Details of the anomaly were further collected to classify hypospadias as anterior hypospadias, middle hypospadias, and posterior hypospadias, as well as an unknown type when no details were available.…”

Section: Methodsmentioning

confidence: 99%

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Association of abnormal placental perfusion with the risk of male hypospadias: a hospital-based retrospective cohort study

Zhu

Zhang

Peng

et al. 2020

BMC Pregnancy Childbirth

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Background The effect and extent of abnormal placental perfusion (APP) on the risk of male hypospadias are poorly understood. We compared the prevalence of male hypospadias in the offspring of women with APP and quantify the extent of the APP effect on the anomaly. Methods A hospital-based retrospective analysis of births from 2012 to 2016 was conducted in 2018. Women of singleton pregnancy and male infants born to them were included (N = 21,447). A multivariate analysis was performed to compare the prevalence of male hypospadias in infants exposed to APP with those that were not exposed to APP. Results Compared with the infants of women without APP, infants of women with APP showed an increased risk of male hypospadias (odds ratio, 2.40; 95% confidence interval, 1.09–5.29). The male hypospadias cumulative risk increased with the severity of APP. Infants exposed to severe APP had a significantly higher risk of male hypospadias than those without APP exposure (9.2 versus 1.7 per 1000 infants, P < 0.001). A path analysis indicated that 28.18–46.61% of the risk of hypospadias may be attributed to the effect of APP. Conclusions Male hypospadias risk was associated with APP and increased with APP severity, as measured in the second trimester. APP had an important role in the development of the anomaly.

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“…However, evidence supporting the generation of risk associated with multi-fetal gestations arising due to the application of excessive ART is limited. Apart from the aforementioned problems, the increased use of ART may also lead to the potential danger of monozygotic twinning, which may contribute to growth abnormalities and twin-to-twin transfusion [ 22 , 23 ]. Such complications could be overcome by appropriate consideration of the maternal condition as well as a thorough assessment of the patient’s obstetric history prior to ART procedures.…”

Section: Assisted Reproductive Technologies In Clinical Practicementioning

confidence: 99%

Nanotechnology in reproductive medicine: Opportunities for clinical translation

Shandilya

Pathak

Lohiya

et al. 2020

Clin Exp Reprod Med

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In recent years, nanotechnology has revolutionized global healthcare and has been predicted to exert a remarkable effect on clinical medicine. In this context, the clinical use of nanomaterials for cancer diagnosis, fertility preservation, and the management of infertility and other pathologies linked to pubertal development, menopause, sexually transmitted infections, and HIV (human immunodeficiency virus) has substantial promise to fill the existing lacunae in reproductive healthcare. Of late, a number of clinical trials involving the use of nanoparticles for the early detection of reproductive tract infections and cancers, targeted drug delivery, and cellular therapeutics have been conducted. However, most of these trials of nanoengineering are still at a nascent stage, and better synergy between pharmaceutics, chemistry, and cutting-edge molecular sciences is needed for effective translation of these interventions from bench to bedside. To bridge the gap between translational outcome and product development, strategic partnerships with the insight and ability to anticipate challenges, as well as an in-depth understanding of the molecular pathways involved, are highly essential. Such amalgamations would overcome the regulatory gauntlet and technical hurdles, thereby facilitating the effective clinical translation of these nano-based tools and technologies. The present review comprehensively focuses on emerging applications of nanotechnology, which holds enormous promise for improved therapeutics and early diagnosis of various human reproductive tract diseases and conditions.

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Association of assisted reproductive technology and multiple pregnancies with the risks of birth defects and stillbirth: A retrospective cohort study

Cited by 31 publications

References 41 publications

Changes in maternal age and prevalence of congenital anomalies during the enactment of China's universal two-child policy (2013–2017) in Zhejiang Province, China: An observational study

Changes in maternal age and prevalence of congenital anomalies during the enactment of China's universal two-child policy (2013–2017) in Zhejiang Province, China: An observational study

Association of abnormal placental perfusion with the risk of male hypospadias: a hospital-based retrospective cohort study

Nanotechnology in reproductive medicine: Opportunities for clinical translation

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