生育治疗与 5 岁单胎儿童的智力、注意力和执行功能：队列研究。

Fertility treatment and child intelligence, attention, and executive functions in 5-year-old singletons: a cohort study.

机构信息

Section for Epidemiology, School of Public Health, Aarhus University, Aarhus, Denmark; The Fertility Clinic, Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark.

出版信息

BJOG. 2014 Dec;121(13):1642-51. doi: 10.1111/1471-0528.12907. Epub 2014 Jun 9.

DOI:10.1111/1471-0528.12907

PMID:24910085

Abstract

OBJECTIVE

To assess the association of fertility treatment and subfertility with offspring intelligence, attention, and executive functions in 5-year-old singletons.

DESIGN

Follow-up study.

SETTING

Denmark 2003-2008.

POPULATION

A cohort of 1782 children sampled from the Danish National Birth Cohort.

METHODS

The children were tested with a neuropsychological battery at age five. In addition to tests of intelligence, attention and executive functions, the follow up included extensive information on important covariates. The analyses were conducted using multiple linear regression and adjusted for parental educational level, maternal intelligence, age, parity, body mass index, smoking in pregnancy, alcohol consumption in pregnancy and child gender, child age, and examiner.

MAIN OUTCOME MEASURES

Wechsler Preschool and Primary Scale of Intelligence-Revised, the Test of Everyday Attention for Children at Five, and the Behavior Rating Inventory of Executive Functions scores.

RESULTS

A consistent pattern of nonsignificantly lower scores were only observed for intelligence and executive functions in children born after fertility treatment or by subfertile parents when the results were unadjusted for maternal intelligence and parental educational level. When adjusted for these and other covariates, there were no significant mean differences in intelligence (mean difference -2.8, 95% CI -7.8, 2.2), overall attention (-0.1, 95% CI -0.6, 0.3), or parent-rated executive functions (-0.1, 95% CI -3.0, 2.9) between children born after spontaneous conception and children born to parents conceiving after fertility treatment. Similarly, there were no significant mean differences in intelligence (mean difference 0.6, 95% CI -2.2, 3.4), overall attention (0.1, 95% CI -0.2, 0.4), or parent-rated executive functions (1.0, 95% CI -1.8, 3.7) between children born after spontaneous conception and children born to subfertile parents waiting more than 12 months before conceiving naturally.

CONCLUSIONS

This study suggests that parental subfertility and fertility treatment are unrelated to offspring intelligence, attention and executive functions.

摘要

目的

评估生育治疗和生育能力低下与 5 岁单胎子女后代智力、注意力和执行功能的关系。

设计

随访研究。

地点

丹麦，2003-2008 年。

人群

从丹麦全国出生队列中抽取的 1782 名儿童队列。

方法

在孩子 5 岁时，使用神经心理学测试对他们进行测试。除了智力、注意力和执行功能测试外，随访还包括对重要协变量的广泛信息。分析采用多元线性回归，调整了父母的教育水平、母亲的智力、年龄、产次、体重指数、孕期吸烟、孕期饮酒和儿童性别、儿童年龄和检查者。

主要观察指标

韦氏学前和小学智力量表修订版、儿童 5 岁日常注意测试和行为评定量表的执行功能评分。

结果

只有在未调整母亲智力和父母教育水平时，生育治疗后或生育能力低下父母所生的儿童的智力和执行功能的结果才显示出一致性的、无统计学意义的较低分数。当调整这些和其他协变量后，在智力（平均差异-2.8，95%CI-7.8，2.2）、总体注意力（-0.1，95%CI-0.6，0.3）或父母评定的执行功能（-0.1，95%CI-3.0，2.9）方面，自然受孕后出生的儿童与生育治疗后受孕的儿童之间没有显著的平均差异。同样，在智力（平均差异 0.6，95%CI-2.2，3.4）、总体注意力（0.1，95%CI-0.2，0.4）或父母评定的执行功能（1.0，95%CI-1.8，3.7）方面，自然受孕后出生的儿童与等待 12 个月以上才自然受孕的生育能力低下的父母所生的儿童之间也没有显著的平均差异。