Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland 20852, USA.
Fertil Steril. 2013 Feb;99(2):311-7. doi: 10.1016/j.fertnstert.2012.12.013.
Initial reports suggested that children conceived with assisted reproductive technologies (ART) may be at increased risk for a spectrum of developmental disabilities. Evolving evidence suggests that some of the early risks may have been overstated when not taking plurality of birth or gestational age at delivery into consideration, as both are independent risk factors for neurodevelopmental disabilities arising from alterations in structure and function or limitations in activities. Continued research is needed to overcome lingering data gaps in light of the equivocal literature for many neurodevelopmental disabilities relative to ART, increasing utilization of services, and changes in the clinical management of infecund couples such as the adoption of natural cycles or in vitro maturation treatment options. Population-based cohorts with longitudinal assessment of the multifaceted nature of neurodevelopment across critical and sensitive windows is paramount for the development of empirically based guidance for clinical and population health.
最初的报告表明，通过辅助生殖技术（ART）受孕的儿童可能面临一系列发育障碍的风险增加。不断发展的证据表明，当不考虑多胎分娩或分娩时的胎龄时，一些早期风险可能被夸大了，因为这两者都是结构和功能改变或活动受限导致神经发育障碍的独立风险因素。鉴于相对于 ART，许多神经发育障碍的文献存在不确定性，需要继续研究以克服挥之不去的数据差距，同时考虑到服务利用率的增加，以及对不育夫妇的临床管理的变化，例如采用自然周期或体外成熟治疗方案。具有神经发育多方面性质的纵向评估的基于人群的队列对于制定基于经验的临床和人群健康指导方针至关重要。
