Tornblad Institute, University of Lund, Biskopsgatan 7, SE-223 62 Lund, Sweden.
Eur J Paediatr Neurol. 2010 Nov;14(6):526-30. doi: 10.1016/j.ejpn.2010.03.007. Epub 2010 May 6.
Infants born after in vitro fertilization (IVF) differ from spontaneously conceived infants in a number of aspects which could increase the risk for future cerebral palsy (CP), e.g., multiple births, preterm births, neonatal complications.
To follow up children conceived by IVF with respect to risk for CP.
Infants born after IVF were identified from all IVF clinics in Sweden 1982-2007. Perinatal characteristics were obtained by linkage with the Medical Birth Register. The presence of CP in children born after IVF and in other children was identified from the Patient Register which contains diagnoses given at hospitalizations or specialist outpatient clinics. The risk for CP after IVF was studied after adjustment for year of birth, maternal age, parity, and smoking, all factors which co-vary both with IVF and with CP. Stratification was made for singletons and multiple births and for various neonatal outcomes.
The adjusted odds ratio for CP after IVF was 1.81 (95% confidence interval, 95% CI 1.52-2.13), lower and not statistically significant when singletons or when unlike-sexed twins were analyzed. Stratification for various neonatal characteristics also reduced odds ratios to non-significant levels. For the last few years of the study (2004-2007) when the twinning rate after IVF was <10%, the odds ratio for CP was 0.97 (95% CI 0.57-1.66).
The moderately increased risk for CP was most likely a consequence of an increased risk of neonatal morbidity, notably associated with multiple births.
体外受精（IVF）出生的婴儿在许多方面与自然受孕的婴儿不同，这些方面可能会增加未来脑瘫（CP）的风险，例如多胎妊娠、早产、新生儿并发症。
对通过 IVF 受孕的儿童进行 CP 风险随访。
从 1982 年至 2007 年，在瑞典的所有 IVF 诊所中识别出通过 IVF 出生的婴儿。通过与医疗出生登记处的链接获得围产期特征。通过包含在住院或专科门诊就诊时给出的诊断的患者登记处，确定通过 IVF 出生的儿童和其他儿童中 CP 的存在。在调整了出生年份、母亲年龄、产次和吸烟等因素后，研究了 IVF 后 CP 的风险，这些因素与 IVF 和 CP 都有共同变化。对单胎和多胎以及各种新生儿结局进行了分层。
调整后的 IVF 后 CP 的比值比为 1.81（95%置信区间，95%CI 1.52-2.13），当分析单胎或异性别双胞胎时，比值比较低且无统计学意义。对各种新生儿特征进行分层也将比值比降低到无统计学意义的水平。在研究的最后几年（2004-2007 年），当 IVF 后的双胞胎率<10%时，CP 的比值比为 0.97（95%CI 0.57-1.66）。
CP 的风险适度增加很可能是新生儿发病率增加的结果，尤其是与多胎妊娠相关。
