Effects of assisted reproductive technology in single pregnancy on the incidence of gestational diabetes: a systematic review and meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

WU Qizhen ¹ , YUAN Tao ^2,3 , ZHANG Lili ¹ , ZHANG Yanhua ¹ , ZHOU Min ¹ , HU Yaguang ¹ ,  QIU Jie ¹ ,  YANG Kehu ^1,3,4

1. The Perinatal Medical Center, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou 730050, P.R.China;
2. Department of Pain Medicine, The First Hospital of Lanzhou University, Lanzhou 730000, P.R.China;
3. Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730030, P.R.China;
4. Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730030, P.R.China;

Corresponding?author：

QIU Jie, Email: Qiujie814102@163.com; YANG Kehu, Email: kehuyangebm2006@126.com

Keywords：

Assisted reproductive technology; Natural pregnancy; Gestational diabetes mellitus; Systematic review; Meta-analysis; Cohort study

DOI：

10.7507/1672-2531.201909029

Video：

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Objective To systematically review the effects of assisted reproductive technology in single pregnancy on the incidence of gestational diabetes.Methods PubMed, EMbase, The Cochrane Library, Web of Science, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect cohort studies on the correlation between assisted reproductive technology (ART) and gestational diabetes mellitus (GDM) incidence in single pregnancy from inception to June 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed by using RevMan 5.3 software.Results A total of 16 cohort studies involving 2 017 573 cases of single pregnancy were included. The results of meta-analysis showed that compared with the natural pregnancy group, the incidence of GDM was higher in the ART group (RR=1.54, 95%CI 1.30 to 1.83, P<0.000 01). In East Asia and Non-East Asia, the incidence of GDM in the ART group was higher than that in the natural pregnancy group (East Asia: RR=1.55, 95%CI 1.26 to 1.92, P<0.000 01; Non-East Asia: RR=1.49, 95%CI 1.18 to 1.89. P<0.000 1).Conclusions Current evidence shows that the incidence of GDM may increase in single pregnancy with ART compared with natural pregnancy. Due to limited quantity and quality of the included studies, more high quality studies are required to verify above conclusions.

Citation： WU Qizhen, YUAN Tao, ZHANG Lili, ZHANG Yanhua, ZHOU Min, HU Yaguang, QIU Jie, YANG Kehu. Effects of assisted reproductive technology in single pregnancy on the incidence of gestational diabetes: a systematic review and meta-analysis. Chinese Journal of Evidence-Based Medicine, 2020, 20(6): 681-687. doi: 10.7507/1672-2531.201909029 Copy

1.	Sullivan EA, Zegers-Hochschild F, Mansour R, et al. International committee for monitoring assisted reproductive technologies (ICMART) world report: assisted reproductive technology 2004. Hum Reprod, 2013, 28(5): 1375-1390.
2.	Amini L, Safaie Z, Jamshidi RA, et al. Maternal outcomes after in vitro fertilization. Int J Fertil Steril, 2015, 9(S1): 102.
3.	Yang X, Li Y, Li C, et al. Current overview of pregnancy complications and live-birth outcome of assisted reproductive technology in mainland China. Fertil Steril, 2014, 101(2): 385-391.
4.	Huang LS, Yen CH, Lee SH, et al. The pregnancy health and birth outcomes of women who underwent assisted reproductive technology: results of a national survey. Iran J Reprod Med, 2011, 9(4): 269-276.
5.	Lie RT, Lyngstadaas A, Orstavik KH, et al. Birth defects in children conceived by ICSI compared with children conceived by other IVF-methods: a meta-analysis. Int J Epidemiol, 2005, 34(3): 696-701.
6.	于淼, 謝華. 體外受精-胚胎移植技術與自然妊娠雙胎母兒圍產結局對比分析. 中國臨床醫生雜志, 2018, 46(9): 1109-1111.
7.	關懷, 尚麗新. 妊娠期糖尿病流行現狀. 中國實用婦科與產科雜志, 2015, 31(1): 91-94.
8.	Wells GA, Shea B, O, Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. Available from: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp.
9.	周晶. 輔助生殖技術對胎兒宮內生長軌跡及妊娠結局的影響. 西安: 中國人民解放軍空軍軍醫大學(第四軍醫大學), 2016.
10.	羅金英, 陳水仙, 卓秀云. 輔助生殖技術助孕單胎妊娠圍生期狀況分析. 福建醫藥雜志, 2013, 35(6): 20-22.
11.	范宏芳. ART 助孕患者與自然妊娠患者單胎母嬰圍生期結局的比較. 鄭州: 鄭州大學, 2017.
12.	康卉嫻, 馬彩虹, 魏瑗, 等. 體外受精-胚胎移植與單胎妊娠早產風險關系研究. 中國實用婦科與產科雜志, 2017, 33(6): 609-612.
13.	章瑜. 輔助生殖技術妊娠安全性臨床分析及胎盤蛋白質組學研究. 杭州: 浙江大學, 2010.
14.	Farhi A, Reichman B, Boyko V, et al. Maternal and neonatal health outcomes following assisted reproduction. Reprod Biomed Online, 2013, 26(5): 454-461.
15.	Harlev A, Walfisch A, Oran E, et al. The effect of fertility treatment on adverse perinatal outcomes in women aged at least 40 years. Int J Gynaecol Obstet, 2018, 140(1): 98-104.
16.	Qin J, Sheng X, Wu D, et al. Adverse obstetric outcomes associated with in vitro fertilization in singleton pregnancies: a prospective cohort study. Reprod Sci, 2017, 24(4): 595-608.
17.	Ginstr?m Ernstad E, Bergh C, Khatibi A, et al. Neonatal and maternal outcome after blastocyst transfer: a population-based registry study. Am J Obstet Gynecol, 2016, 214(3): 378.
18.	Ochsenkühn R, Strowitzki T, Gurtner M, et al. Pregnancy complications, obstetric risks, and neonatal outcome in singleton and twin pregnancies after GIFT and IVF. Arch Gynecol Obstet, 2003, 268(4): 256-261.
19.	Pochiraju M, Nirmalan PK. Type of conception and outcomes in women with singleton pregnancy. J Clin Diagn Res, 2014, 8(2): 103-105.
20.	Sazonova A, K?llen K, Thurin-Kjellberg A, et al. Obstetric outcome in singletons after in vitro fertilization with cryopreserved/thawed embryos. Hum Reprod, 2012, 27(5): 1343-1350.
21.	Silberstein T, Levy A, Harlev A, et al. Perinatal outcome of pregnancies following in vitro fertilization and ovulation induction. J Matern Fetal Neonatal Med, 2014, 27(13): 1316-1319.
22.	Stojnic J, Radunovic N, Jeremic K, et al. Perinatal outcome of singleton pregnancies following in vitro fertilization. Clin Exp Obstet Gynecol, 2013, 40(2): 277-283.
23.	Suzuki S, Miyake H. Obstetric outcomes of elderly primiparous singleton pregnancies conceived by in vitro fertilization compared with those conceired spontaneously. Reprod Med Biol, 2007, 6(4): 219-222.
24.	Zddori J, Kozinszky Z, Orvos H, et al. Dilemma of increased obstetric risk in pregnancies following IVF-ET. J Assist Reprod Genet, 2003, 20(6): 216-221.
25.	Li T, Vu TH, Ulaner GA, et al. IVF results in de novo DNA methylation and histone methylation at an Igf2-H19 imprinting epigenetic switch. Mol Hum Reprod, 2005, 11(9): 631-640.
26.	Zhang YL, Chen T, Jiang Y, et al. Active demethylation of individual genes in intracytoplasmic sperm injection rabbit embryos. Mol Reprod Dev, 2005, 72(4): 530-533.
27.	Bateson P, Barker D, Clutton-Brock T, et al. Developmental plasticity and human health. Nature, 2004, 430(6998): 419-421.
28.	Tobias DK, Chavarro JE, Williams MA, et al. History of infertility and risk of gestational diabetes mellitus: a prospective analysis of 40,773 pregnancies. Am J Epidemiol, 2013, 178(8): 1219-1225.
29.	Holst S, Kj?r SK, J?rgensen ME, et al. Fertility problems and risk of gestational diabetes mellitus: a nationwide cohort study. Fertil Steril, 2016, 106(2): 427-434.
30.	Bals-Pratsch M, Grosser B, Seifert B, et al. Early onset and high prevalence of gestational diabetes in PCOS and insulin resistant women before and after assisted reproduction. Exp Clin Endocrinol Diabetes, 2011, 119(6): 338-342.
31.	Gurevitch J, Koricheva J, Nakagawa S, et al. Meta-analysis and the science of research synthesis. Nature, 2018, 555(7695): 175-182.
32.	楊克虎, 李秀霞, 拜爭剛. 循證社會科學研究方法: 系統評價與 Meta 分析. 蘭州: 蘭州大學出版社, 2018.
33.	楊克虎. 循證社會科學的產生, 發展與未來. 圖書與情報, 2018, (3): 1-10.
34.	Bals-Pratsch M, Malfertheiner SF. Glucose metabolism and assisted reproduction. Gynecol Endocr, 2017, 15(2): 108-115.
35.	Poolsup N, Suksomboon N, Amin M. Effect of treatment of gestational diabetes mellitus: a systematic review and meta-analysis. PLoS One, 2014, 9(3): e9248.

1. Sullivan EA, Zegers-Hochschild F, Mansour R, et al. International committee for monitoring assisted reproductive technologies (ICMART) world report: assisted reproductive technology 2004. Hum Reprod, 2013, 28(5): 1375-1390.
2. Amini L, Safaie Z, Jamshidi RA, et al. Maternal outcomes after in vitro fertilization. Int J Fertil Steril, 2015, 9(S1): 102.
3. Yang X, Li Y, Li C, et al. Current overview of pregnancy complications and live-birth outcome of assisted reproductive technology in mainland China. Fertil Steril, 2014, 101(2): 385-391.
4. Huang LS, Yen CH, Lee SH, et al. The pregnancy health and birth outcomes of women who underwent assisted reproductive technology: results of a national survey. Iran J Reprod Med, 2011, 9(4): 269-276.
5. Lie RT, Lyngstadaas A, Orstavik KH, et al. Birth defects in children conceived by ICSI compared with children conceived by other IVF-methods: a meta-analysis. Int J Epidemiol, 2005, 34(3): 696-701.
6. 于淼, 謝華. 體外受精-胚胎移植技術與自然妊娠雙胎母兒圍產結局對比分析. 中國臨床醫生雜志, 2018, 46(9): 1109-1111.
7. 關懷, 尚麗新. 妊娠期糖尿病流行現狀. 中國實用婦科與產科雜志, 2015, 31(1): 91-94.
8. Wells GA, Shea B, O, Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. Available from: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp.
9. 周晶. 輔助生殖技術對胎兒宮內生長軌跡及妊娠結局的影響. 西安: 中國人民解放軍空軍軍醫大學(第四軍醫大學), 2016.
10. 羅金英, 陳水仙, 卓秀云. 輔助生殖技術助孕單胎妊娠圍生期狀況分析. 福建醫藥雜志, 2013, 35(6): 20-22.
11. 范宏芳. ART 助孕患者與自然妊娠患者單胎母嬰圍生期結局的比較. 鄭州: 鄭州大學, 2017.
12. 康卉嫻, 馬彩虹, 魏瑗, 等. 體外受精-胚胎移植與單胎妊娠早產風險關系研究. 中國實用婦科與產科雜志, 2017, 33(6): 609-612.
13. 章瑜. 輔助生殖技術妊娠安全性臨床分析及胎盤蛋白質組學研究. 杭州: 浙江大學, 2010.
14. Farhi A, Reichman B, Boyko V, et al. Maternal and neonatal health outcomes following assisted reproduction. Reprod Biomed Online, 2013, 26(5): 454-461.
15. Harlev A, Walfisch A, Oran E, et al. The effect of fertility treatment on adverse perinatal outcomes in women aged at least 40 years. Int J Gynaecol Obstet, 2018, 140(1): 98-104.
16. Qin J, Sheng X, Wu D, et al. Adverse obstetric outcomes associated with in vitro fertilization in singleton pregnancies: a prospective cohort study. Reprod Sci, 2017, 24(4): 595-608.
17. Ginstr?m Ernstad E, Bergh C, Khatibi A, et al. Neonatal and maternal outcome after blastocyst transfer: a population-based registry study. Am J Obstet Gynecol, 2016, 214(3): 378.
18. Ochsenkühn R, Strowitzki T, Gurtner M, et al. Pregnancy complications, obstetric risks, and neonatal outcome in singleton and twin pregnancies after GIFT and IVF. Arch Gynecol Obstet, 2003, 268(4): 256-261.
19. Pochiraju M, Nirmalan PK. Type of conception and outcomes in women with singleton pregnancy. J Clin Diagn Res, 2014, 8(2): 103-105.
20. Sazonova A, K?llen K, Thurin-Kjellberg A, et al. Obstetric outcome in singletons after in vitro fertilization with cryopreserved/thawed embryos. Hum Reprod, 2012, 27(5): 1343-1350.
21. Silberstein T, Levy A, Harlev A, et al. Perinatal outcome of pregnancies following in vitro fertilization and ovulation induction. J Matern Fetal Neonatal Med, 2014, 27(13): 1316-1319.
22. Stojnic J, Radunovic N, Jeremic K, et al. Perinatal outcome of singleton pregnancies following in vitro fertilization. Clin Exp Obstet Gynecol, 2013, 40(2): 277-283.
23. Suzuki S, Miyake H. Obstetric outcomes of elderly primiparous singleton pregnancies conceived by in vitro fertilization compared with those conceired spontaneously. Reprod Med Biol, 2007, 6(4): 219-222.
24. Zddori J, Kozinszky Z, Orvos H, et al. Dilemma of increased obstetric risk in pregnancies following IVF-ET. J Assist Reprod Genet, 2003, 20(6): 216-221.
25. Li T, Vu TH, Ulaner GA, et al. IVF results in de novo DNA methylation and histone methylation at an Igf2-H19 imprinting epigenetic switch. Mol Hum Reprod, 2005, 11(9): 631-640.
26. Zhang YL, Chen T, Jiang Y, et al. Active demethylation of individual genes in intracytoplasmic sperm injection rabbit embryos. Mol Reprod Dev, 2005, 72(4): 530-533.
27. Bateson P, Barker D, Clutton-Brock T, et al. Developmental plasticity and human health. Nature, 2004, 430(6998): 419-421.
28. Tobias DK, Chavarro JE, Williams MA, et al. History of infertility and risk of gestational diabetes mellitus: a prospective analysis of 40,773 pregnancies. Am J Epidemiol, 2013, 178(8): 1219-1225.
29. Holst S, Kj?r SK, J?rgensen ME, et al. Fertility problems and risk of gestational diabetes mellitus: a nationwide cohort study. Fertil Steril, 2016, 106(2): 427-434.
30. Bals-Pratsch M, Grosser B, Seifert B, et al. Early onset and high prevalence of gestational diabetes in PCOS and insulin resistant women before and after assisted reproduction. Exp Clin Endocrinol Diabetes, 2011, 119(6): 338-342.
31. Gurevitch J, Koricheva J, Nakagawa S, et al. Meta-analysis and the science of research synthesis. Nature, 2018, 555(7695): 175-182.
32. 楊克虎, 李秀霞, 拜爭剛. 循證社會科學研究方法: 系統評價與 Meta 分析. 蘭州: 蘭州大學出版社, 2018.
33. 楊克虎. 循證社會科學的產生, 發展與未來. 圖書與情報, 2018, (3): 1-10.
34. Bals-Pratsch M, Malfertheiner SF. Glucose metabolism and assisted reproduction. Gynecol Endocr, 2017, 15(2): 108-115.
35. Poolsup N, Suksomboon N, Amin M. Effect of treatment of gestational diabetes mellitus: a systematic review and meta-analysis. PLoS One, 2014, 9(3): e9248.

Chinese Journal of Evidence-Based Medicine

Effects of assisted reproductive technology in single pregnancy on the incidence of gestational diabetes: a systematic review and meta-analysis

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