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, 谢华. 体外受精-胚胎移植技术与自然妊娠双胎母儿围产结局对比分析. 中国临床医生杂志, 2018, 46(9): 1109-1111.
7.	关怀, 尚丽新. 妊娠期糖尿病流行现状. 中国实用妇科与产科杂志, 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. 辅助生殖技术对胎儿宫内生长轨迹及妊娠结局的影响. 西安: 中国人民解放军空军军医大学(第四军医大学), 2016.
10.	罗金英, 陈水仙, 卓秀云. 辅助生殖技术助孕单胎妊娠围生期状况分析. 福建医药杂志, 2013, 35(6): 20-22.
11.	范宏芳. ART 助孕患者与自然妊娠患者单胎母婴围生期结局的比较. 郑州: 郑州大学, 2017.
12.	康卉娴, 马彩虹, 魏瑗, 等. 体外受精-胚胎移植与单胎妊娠早产风险关系研究. 中国实用妇科与产科杂志, 2017, 33(6): 609-612.
13.	章瑜. 辅助生殖技术妊娠安全性临床分析及胎盘蛋白质组学研究. 杭州: 浙江大学, 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.	Ginström 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, Källen 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, Kjær SK, Jørgensen 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.	杨克虎, 李秀霞, 拜争刚. 循证社会科学研究方法: 系统评价与 Meta 分析. 兰州: 兰州大学出版社, 2018.
33.	杨克虎. 循证社会科学的产生, 发展与未来. 图书与情报, 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, 谢华. 体外受精-胚胎移植技术与自然妊娠双胎母儿围产结局对比分析. 中国临床医生杂志, 2018, 46(9): 1109-1111.
7. 关怀, 尚丽新. 妊娠期糖尿病流行现状. 中国实用妇科与产科杂志, 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. 辅助生殖技术对胎儿宫内生长轨迹及妊娠结局的影响. 西安: 中国人民解放军空军军医大学(第四军医大学), 2016.
10. 罗金英, 陈水仙, 卓秀云. 辅助生殖技术助孕单胎妊娠围生期状况分析. 福建医药杂志, 2013, 35(6): 20-22.
11. 范宏芳. ART 助孕患者与自然妊娠患者单胎母婴围生期结局的比较. 郑州: 郑州大学, 2017.
12. 康卉娴, 马彩虹, 魏瑗, 等. 体外受精-胚胎移植与单胎妊娠早产风险关系研究. 中国实用妇科与产科杂志, 2017, 33(6): 609-612.
13. 章瑜. 辅助生殖技术妊娠安全性临床分析及胎盘蛋白质组学研究. 杭州: 浙江大学, 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. Ginström 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, Källen 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, Kjær SK, Jørgensen 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. 杨克虎, 李秀霞, 拜争刚. 循证社会科学研究方法: 系统评价与 Meta 分析. 兰州: 兰州大学出版社, 2018.
33. 杨克虎. 循证社会科学的产生, 发展与未来. 图书与情报, 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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