Gucuyener Kivilcim, Arhan Ebru, Soysal A Sebnem, Ergenekon Ebru, Turan Ozden, Onal Esra, Koç Esin, Turkyilmaz Canan, Atalay Yildiz
Department of Pediatric Neurology, Gazi University Faculty of Medicine, Ankara, Turkey.
Pediatr Int. 2011 Dec;53(6):944-9. doi: 10.1111/j.1442-200X.2011.03425.x.
The aim of the present study was to determine language levels in twins and singletons born after at least 34 weeks gestation and without identifiable neurological abnormality and to evaluate whether in vitro fertilization (IVF) affects language development in twin pregnancies.
A prospective study of a large cohort of all children born between 1 January 2001 and 31 December 2003 was carried out at Gazi University Hospital. All live-born twin pairs in which both twins survived were identified, and a comparable sample of families with pairs of singletons were chosen. The Stanford-Binet Intelligence Scale Form and the translated Turkish form of the Peabody Picture Vocabulary Test were completed at 60 months.
Even after excluding the most premature twins and those with diagnosable neurological damage, twins performed worse than singletons on language development tests. Twin girls had better scores than twin boys. A statistically significant difference was found between the scores of term and preterm twins. No significant difference was noted when compared according to birth order. Appropriate for gestational age (AGA) twins did better than small for gestational age (SGA) twins in the test scores. All twin girls did not differ from singleton girls, but all twin boys performed worse than singleton boys. Term twins had similar results with term singletons, but preterm twins had lower scores than preterm singletons. SGA singletons had better scores than SGA twins, while AGA twins and singletons did not differ. When the children were compared with regard to method of conception, IVF children had significantly lower scores on the tests than those in the spontaneous conception group.
It is hoped that the present findings could lead to a more precise assessment of children for speech impairment and, above all, to more efficient preventive intervention. Whatever mechanisms are involved, the present results indicate that twins born as a result of IVF, are at a disadvantage in terms of language development in comparison with spontaneously conceived twins.
本研究的目的是确定孕34周及以上出生、无明显神经异常的双胞胎和单胎婴儿的语言水平，并评估体外受精（IVF）是否会影响双胎妊娠中的语言发育。
在加齐大学医院对2001年1月1日至2003年12月31日期间出生的所有儿童进行了一项大型队列前瞻性研究。确定了所有存活的双胞胎对，其中两个双胞胎均存活，并选择了具有可比样本的单胎家庭。在60个月时完成了斯坦福-比奈智力量表和皮博迪图片词汇测试的土耳其语翻译版。
即使排除了最早出生的双胞胎和那些有可诊断神经损伤的双胞胎，双胞胎在语言发育测试中的表现仍比单胎差。双胞胎女孩的得分高于双胞胎男孩。足月和早产双胞胎的得分之间存在统计学上的显著差异。按出生顺序比较时未发现显著差异。适于胎龄（AGA）双胞胎在测试分数上比小于胎龄（SGA）双胞胎表现更好。所有双胞胎女孩与单胎女孩没有差异，但所有双胞胎男孩的表现比单胎男孩差。足月双胞胎与足月单胎结果相似，但早产双胞胎得分低于早产单胎。SGA单胎得分高于SGA双胞胎，而AGA双胞胎和单胎没有差异。当比较孩子的受孕方式时，IVF孩子在测试中的得分显著低于自然受孕组的孩子。
希望本研究结果能导致对儿童言语障碍进行更精确的评估，最重要的是能进行更有效的预防性干预。无论涉及何种机制，目前的结果表明，与自然受孕的双胞胎相比，IVF出生的双胞胎在语言发育方面处于劣势。
