Ceelen Manon, van Weissenbruch Mirjam M, Vermeiden Jan P W, van Leeuwen Flora E, Delemarre-van de Waal Henriette A
Department of Paediatrics, VU University Medical Center, De Boelelaan 1117, Amsterdam, The Netherlands.
J Clin Endocrinol Metab. 2008 May;93(5):1682-8. doi: 10.1210/jc.2007-2432. Epub 2008 Feb 19.
Increasing evidence suggests that adverse conditions during early prenatal life are associated with cardiometabolic dysfunction in postnatal life. In vitro fertilization (IVF) conception may be an early prenatal life event with long-term health consequences.
Our objective was to investigate several cardiometabolic measures in 8- to 18-yr-old IVF singletons and spontaneously conceived controls born from subfertile parents.
This follow-up study was conducted at the VU University Medical Center, Amsterdam, The Netherlands.
Blood pressure was examined in 225 IVF-conceived children and 225 age- and gender-matched spontaneously conceived control children. Several indicators of insulin resistance were studied in a pubertal subpopulation (131 IVF children and 131 controls).
Blood pressure, fasting glucose, and fasting insulin were determined.
Systolic and diastolic blood pressure levels were higher in IVF children than controls (109 +/- 11 vs. 105 +/- 10 mm Hg, P < 0.001; and 61 +/- 7 vs. 59 +/- 7 mm Hg, P < 0.001, respectively). Children born after IVF were also more likely to be in the highest systolic and diastolic blood pressure quartiles (odds ratio = 2.1, 95% confidence interval 1.4, 3.3; odds ratio = 1.9, 95% confidence interval 1.2, 3.0, respectively). Furthermore, higher fasting glucose levels were observed in pubertal IVF children (5.0 +/- 0.4 vs. 4.8 +/- 0.4 mmol/liter in controls; P = 0.005). Blood pressure and fasting glucose differences could not be explained by current body size, birth weight, and other early life factors or by parental characteristics, including subfertility cause.
These findings highlight the importance of continued cardiometabolic monitoring of IVF-conceived children and might contribute to current knowledge about periconceptional influences and their consequences in later life.
越来越多的证据表明，孕期早期的不良状况与出生后心脏代谢功能障碍有关。体外受精（IVF）受孕可能是一个对长期健康有影响的孕期早期事件。
我们的目的是调查8至18岁由不孕不育父母所生的IVF单胎婴儿和自然受孕的对照儿童的多项心脏代谢指标。
这项随访研究在荷兰阿姆斯特丹的VU大学医学中心进行。
对225名IVF受孕儿童和225名年龄及性别匹配的自然受孕对照儿童进行了血压检查。在一个青春期亚组（131名IVF儿童和131名对照）中研究了胰岛素抵抗的几个指标。
测定血压、空腹血糖和空腹胰岛素。
IVF儿童的收缩压和舒张压水平高于对照组（分别为109±11与105±10 mmHg，P<0.001；61±7与59±7 mmHg，P<0.001）。IVF出生的儿童也更有可能处于收缩压和舒张压最高的四分位数（优势比分别为2.1，95%置信区间1.4，3.3；优势比为1.9，95%置信区间1.2，3.0）。此外，青春期IVF儿童的空腹血糖水平更高（对照组为5.0±0.4与4.8±0.4 mmol/升；P = 0.005）。血压和空腹血糖的差异无法用当前的体型、出生体重和其他早期生活因素或父母特征（包括不孕不育原因）来解释。
这些发现凸显了对IVF受孕儿童持续进行心脏代谢监测的重要性，并可能有助于增进我们对受孕前后影响及其对晚年后果的现有认识。
