Zhu Jin Liang, Basso Olga, Obel Carsten, Hvidtjørn Dorte, Olsen Jørn
The Danish Epidemiology Science Centre, University of Aarhus, Aarhus, Denmark.
Paediatr Perinat Epidemiol. 2009 Mar;23(2):98-106. doi: 10.1111/j.1365-3016.2008.00989.x.
Babies born of infertile couples, regardless of treatment, have a higher risk of preterm birth and low birthweight, conditions associated with delayed development. We examined developmental milestones in singletons as a function of parental infertility [time to pregnancy (TTP) > 12 months] and infertility treatment. From the Danish National Birth Cohort (1997-2003), we identified 37 897 singletons born of fertile couples (TTP < or = 12 months), 4351 born of infertile couples conceiving naturally (TTP > 12 months), and 3309 born after infertility treatment. When the children were about 18 months old, mothers reported 12 developmental milestones by responding to structured questions. We defined a failure to achieve the assessed milestone or the minimal numbers of milestones in a summary (motor, or cognitive/language skills) as delay. Naturally conceived children born of infertile couples had a pattern of psychomotor development similar to that of children born of fertile couples, but increasing TTP correlated with a modest delay. When the analysis was restricted to infertile couples (treated and untreated), children born after treatment showed a slight delay in cognitive/language development (odds ratio 1.24, [95% confidence interval 1.01, 1.53]) for not meeting at least three out of six cognitive/language milestones); children born after intracytoplasmic sperm injection (ICSI) had the highest estimated relative risk of delay for most milestones, especially motor milestones. These results suggest that a long TTP may be associated with a modest developmental delay. Infertility treatment, especially ICSI, may be associated with a slight delay for some of these early milestones.
不育夫妇所生的婴儿，无论是否接受治疗，早产和低出生体重的风险都更高，这些情况与发育迟缓有关。我们研究了单胎婴儿的发育里程碑，将其作为父母不育[受孕时间（TTP）>12个月]和不育治疗的函数。从丹麦国家出生队列（1997 - 2003年）中，我们确定了37897名单胎婴儿由可育夫妇所生（TTP≤12个月），4351名单胎婴儿由自然受孕的不育夫妇所生（TTP>12个月），以及3309名单胎婴儿在接受不育治疗后出生。当孩子大约18个月大时，母亲们通过回答结构化问题报告了12个发育里程碑。我们将未能达到评估的里程碑或在总结中（运动或认知/语言技能）未能达到最低数量的里程碑定义为发育迟缓。不育夫妇自然受孕的孩子的心理运动发育模式与可育夫妇所生孩子的模式相似，但TTP增加与适度的发育迟缓相关。当分析仅限于不育夫妇（接受治疗和未接受治疗）时，治疗后出生的孩子在认知/语言发育方面表现出轻微延迟（优势比1.24，[95%置信区间1.01，1.53]），即未能达到六个认知/语言里程碑中的至少三个）；卵胞浆内单精子注射（ICSI）后出生的孩子在大多数里程碑方面，尤其是运动里程碑方面，延迟的估计相对风险最高。这些结果表明，较长的TTP可能与适度的发育迟缓有关。不育治疗，尤其是ICSI，可能与这些早期里程碑中的一些轻微延迟有关。
