Assisted reproductive technology and risk of asthma and allergy in the offspring: protocol for a systematic review and meta-analysis

Abstract

IntroductionThe use of assisted reproductive technology (ART) procedures has increased globally over the last three decades. Recent observational studies suggest that children conceived through ART may be at increased risk of asthma and atopic disease compared with children conceived naturally, but findings are mixed. We aim to synthesise the evidence on the impact of ART on the risk of asthma and atopic disease in the offspring.Methods and analysisWe will identify relevant studies by searching MEDLINE, EMBASE, Cochrane Library, ISI Web of Science, CINAHL, Scopus, Google Scholar, AMED, Global Health, PsychINFO, CAB International and the WHO Global Health Library from 1978 to 2016. We will locate additional studies through searching databases of the proceedings of international conferences, contacting international experts in the field, and searching the references cited in identified studies. We will include analytic observational studies (cohort studies, case–control studies and cross-sectional studies) that have investigated the impact of any type of ART on offspring's asthma and atopic disease. Screening of identified records, data extraction from eligible studies and risk of bias assessment of eligible studies will be independently undertaken by two reviewers, with arbitration by a third reviewer. The Effective Public Health Practice Project will be employed for risk of bias assessment. Estimates from studies judged to be clinically, methodologically and statistically homogeneous will be synthesised using random-effects meta-analysis.Ethics and disseminationAs this study is based solely on the published literature, no ethics approval is required. We will publish our findings in a peer-reviewed scientific journal and present the results at national and international scientific conferences.Protocol registrationWe will register a detailed protocol for the review with the International Prospective Register of Systematic Reviews (PROSPERO) prior to starting the review.

Long‐term pediatric skin eruption‐related hospitalizations in offspring conceived via fertility treatment

“…These findings are in agreement with previously published data reporting that rates of asthma, wheezing, and use of antiasthmatic medications are higher among children born to subfertile couples, most apparent at the age of 5 years . Atopic dermatitis, the most prominent representative of allergic eruptions, is a chronic relapsing inflammatory skin disease diagnosed by its characteristic distribution of eczematous skin lesions, marked pruritus, and dry skin.…”

“…Different studies resulted in conflicting conclusions regarding the relationship between fertility treatment and the risk of asthma and atopic disorders in children . The possible biological mechanism for these associations has not been clearly addressed, although concerns have been raised regarding confounders such as immune modifying maternal factors during pregnancy, preexisting asthma and allergy, or other common extrinsic factors such as medication and smoking …”

“…15 The possible biological mechanism for these associations has not been clearly addressed, although concerns have been raised regarding confounders such as immune modifying maternal factors during pregnancy, preexisting asthma and allergy, or other common extrinsic factors such as medication and smoking. 15,16 We therefore sought to explore a possible association between mode of conception and the incidence of eruptive skin conditions in the offspring by conducting this population-based cohort analysis in children up to the age of 18 years stratified according to mode of conception.…”

Alteration in the expression of the renin-angiotensin system in the myocardium of mice conceived by in vitro fertilization†

“…Data has shown that during the periconceptional period, the oocyte and embryo are highly sensitive to signals from their surrounding environment and as such, are particularly susceptible to damage which might manifest in an altered adult phenotype [4]. Follow-up studies on the growth and development of ART-conceived human offspring have aroused widespread concern as their findings indicate that when compared with naturally conceived newborns those conceived by IVF are at greater risk of low birth weight, increasing their susceptibility in adulthood to cardiovascular disease and diabetes [5][6][7]. These data are of particular concern given the extensive clinical application of ART and a large number of resultant ART-conceived offspring [8].…”

Clinical efficacy of recombinant human latrophilin 3 antibody in the treatment of pediatric asthma

“…Asthma is known to be a heterogeneous pulmonary disease characterized by chronic airway inflammation, leading to respiratory swelling and dyspnea (2)(3)(4). It has been demonstrated that mast cells, eosinophil granulocytes, cytokines and T cells serve essential roles in the initiation and progression of pediatric asthma (5,6). Previous studies have also indicated that the inflammatory factors matrix metalloproteinase-9 (MMP-9) and transforming growth factor-β (TGF-β) induced by immunocytes are closely correlated with airway inflammation and airway remodeling (7,8).…”