Bouillon C, Fauque P
Laboratoire de biologie de la reproduction, université de Bourgogne, hôpital de Dijon, 14, rue Gaffarel, 21079 Dijon, France.
Arch Pediatr. 2013 May;20(5):575-9. doi: 10.1016/j.arcped.2013.02.003. Epub 2013 Mar 30.
Since the birth of the first baby conceived by in vitro fertilization (IVF) 30 years ago (Louise Brown in 1978), there has been a rapid and constant increase in the number of couples using assisted reproductive technologies (ART). Around four million of children have been born from couples experiencing fertility problems, through the use of ART, comprising roughly 2-3 % of all births in Europe and U.S. That highlights that these modes of fertilization are now well assumed by our societies. However, several questions on health of these children remain to be elucidated. As evoked in this review, even if methodological limitations exist, numerous studies have reported increased risks of birth defects, like prematurity, foetal hypotrophy, neonatal complications, congenital malformations and epigenetic diseases among ART-conceived children as compared to naturally conceived children. Nowadays, it is difficult to determine if these increased risks found in ART infants are a consequence of the ART procedures or are inherent to the infertility problems per se. However, absolute risks remain moderate and reassuring as well as the data on follow-up into infancy and early childhood. Nevertheless, because the effects may occur at the adulthood, there is a need for long-term follow-up of children born after ART.
自30年前首例体外受精(IVF)婴儿诞生(1978年的路易丝·布朗)以来,使用辅助生殖技术(ART)的夫妇数量一直在快速且持续增加。通过ART,约有400万患有生育问题的夫妇诞下了孩子,这一数字在欧洲和美国约占所有出生人口的2%至3%。这表明我们的社会如今已很好地接纳了这些受精方式。然而,这些孩子的健康仍存在一些问题有待阐明。正如本综述中所提及的,尽管存在方法学上的局限性,但大量研究报告称,与自然受孕的孩子相比,ART受孕的孩子出现出生缺陷的风险增加,如早产、胎儿发育迟缓、新生儿并发症、先天性畸形和表观遗传疾病。如今,很难确定ART婴儿中发现的这些风险增加是ART程序的结果,还是不孕问题本身所固有的。然而,绝对风险仍然适中且令人安心,关于婴儿期和幼儿期随访的数据也是如此。尽管如此,由于这些影响可能在成年期出现,因此有必要对ART出生的儿童进行长期随访。