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体外受精治疗所生育儿童的长期健康结局。第二部分——精神健康和发育结局。

The longer-term health outcomes for children born as a result of IVF treatment. Part II--Mental health and development outcomes.

机构信息

School of Women's and Infant's Health, University of Western Australia, King Edward Memorial Hospital, Subiaco, Perth, WA 6008, Australia.

出版信息

Hum Reprod Update. 2013 May-Jun;19(3):244-50. doi: 10.1093/humupd/dmt002. Epub 2013 Feb 28.

Abstract

BACKGROUND Limited data exist with regard to longer-term mental health and psychological functioning of children born from IVF treatment. With the known adverse perinatal outcome for children born from IVF treatment, it would be expected that there is a negative impact upon their mental development. METHODS A search strategy restricted to studies relating to the medical condition of children of at least 1 year of age, born from IVF treatment was performed to include case series, data linkage and prospective studies published from 1 January 2000 to 1 April 2012. RESULTS Limited long-term follow-up data suggest that there is an increase in the incidence of cerebral palsy and neurodevelopmental delay related to the confounders of prematurity and low birthweight. Previous reports of associations with autism and attention-deficit disorder are believed to be related to maternal and obstetric factors. There exists a potential increase in the prevalence of early adulthood clinical depression and binge drinking in the offspring of IVF, with the reassuring data of no changes with respect to cognitive development, school performance, social functioning and behaviour. Whether these potential associations are related to the IVF treatment, the adverse obstetric outcomes associated with IVF treatment, the genetic or subsequent environmental influences on the children is yet to be determined. CONCLUSIONS In general, the longer-term mental and emotional health outcome for children born from IVF treatment is reassuring, and is very similar to that of naturally conceived children; however, further studies are required to explore any association with depression, and its causality in more detail.

摘要

背景

关于体外受精(IVF)治疗所生育儿童的长期心理健康和心理功能的数据有限。鉴于 IVF 治疗所生育儿童的围产期结局已知存在不良情况,预计这将对其精神发育产生负面影响。

方法

我们采用了一种仅针对与 IVF 治疗所生育儿童的医疗状况相关的研究的搜索策略,包括病例系列、数据关联和前瞻性研究,这些研究的发表时间限制在 2000 年 1 月 1 日至 2012 年 4 月 1 日。

结果

有限的长期随访数据表明,脑瘫和与早产和低出生体重相关的神经发育迟缓的发病率增加。以前关于自闭症和注意力缺陷障碍的关联报告被认为与母体和产科因素有关。IVF 后代中早期成年期临床抑郁症和狂饮的患病率存在潜在增加,令人欣慰的是,认知发展、学业成绩、社会功能和行为方面没有变化。这些潜在的关联是否与 IVF 治疗、与 IVF 治疗相关的不良产科结局、儿童的遗传或后续环境影响有关,尚待确定。

结论

一般来说,IVF 治疗所生育儿童的长期心理健康和情绪健康结果令人安心,与自然受孕儿童非常相似;然而,需要进一步研究来更详细地探讨与抑郁症的任何关联及其因果关系。

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