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对5岁的卵胞浆内单精子注射(ICSI)儿童的心理随访研究。

Psychological follow-up study of 5-year-old ICSI children.

作者信息

Ponjaert-Kristoffersen I, Tjus T, Nekkebroeck J, Squires J, Verté D, Heimann M, Bonduelle M, Palermo G, Wennerholm U-B

机构信息

Department of Developmental- and Lifespanpsychology, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium.

出版信息

Hum Reprod. 2004 Dec;19(12):2791-7. doi: 10.1093/humrep/deh511. Epub 2004 Sep 9.

Abstract

BACKGROUND

The developmental outcomes of children born after ICSI are still a matter of concern. The purpose of the present study was to investigate psychological outcomes for 5-year-old children born after ICSI and compare these with outcomes for children born after spontaneous conception (SC).

METHODS

Three hundred singleton children born after ICSI in Belgium, Sweden and the USA were matched by maternal age, child age and gender. Outcome measures included the Wechsler Preschool and Primary scales of intelligence (WPPSI-R), Peabody Developmental Motor Scales, Parenting Stress Index and Child Behaviour Checklist.

RESULTS

Regarding cognitive development, no significant differences were found on WPPSI-R verbal and performance scales between ICSI and SC children. However, some differences were noted on subtests of the Performance Scale. ICSI children more often obtained a score below 1 SD of the mean on the subtests: Object Assembly, Block Design and Mazes (all P<0.05). Significant differences by site (i.e. Belgium, Sweden and New York) were found on subtests related to parenting stress, child behaviour problems and motor development (all P<0.05). These findings can probably be explained by variables other than conception mode, such as cultural differences and selection bias.

CONCLUSIONS

Although the finding that a higher proportion of ICSI children obtained scores below the cut-off on some of the visual-spatial subscales of the WPPSI-R warrants further investigation, ICSI does not appear to affect the psychological well-being or cognitive development at age 5.

摘要

背景

通过卵胞浆内单精子注射(ICSI)出生的儿童的发育结局仍是一个令人担忧的问题。本研究的目的是调查ICSI出生的5岁儿童的心理结局,并将其与自然受孕(SC)出生的儿童的结局进行比较。

方法

对比利时、瑞典和美国300名单胎ICSI出生的儿童,按照母亲年龄、孩子年龄和性别进行匹配。结局指标包括韦氏学前和小学智力量表(WPPSI-R)、皮博迪发育运动量表、育儿压力指数和儿童行为清单。

结果

在认知发展方面,ICSI儿童和SC儿童在WPPSI-R语言和操作量表上未发现显著差异。然而,在操作量表的子测试中发现了一些差异。ICSI儿童在以下子测试中得分低于均值1个标准差的情况更为常见:图形拼凑、积木图案和迷宫(所有P<0.05)。在与育儿压力、儿童行为问题和运动发育相关的子测试中,发现了按地点(即比利时、瑞典和纽约)划分的显著差异(所有P<0.05)。这些发现可能可以用受孕方式以外的变量来解释,如文化差异和选择偏差。

结论

尽管发现较高比例的ICSI儿童在WPPSI-R的一些视觉空间子量表上得分低于临界值这一情况值得进一步研究,但ICSI似乎不会影响5岁时的心理健康或认知发展。

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