Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands.
School for Oncology and Developmental Biology, GROW, Maastricht University, Maastricht, The Netherlands.
Hum Reprod. 2018 Nov 1;33(11):2150-2157. doi: 10.1093/humrep/dey302.
Does PGD increase the risk on adverse cognitive and socio-emotional development?
The cognitive and socio-emotional development in children born after PGD seems to be normal when compared to control groups.
A limited number of studies with small sample sizes indicate that the cognitive and socio-emotional development of (pre)school-aged children born after either PGD or PGS seem to be comparable to those of children born after IVF/ICSI and to naturally conceived (NC) children from the general population.
STUDY DESIGN, SIZE, DURATION: For this study we invited 72 5-year-old PGD children, 128 5-year-old IVF/ICSI children and 108 5-year-old NC children from families with a genetic disorder. All children were invited between January 2014 and July 2016.
PARTICIPANTS/MATERIALS, SETTING, METHODS: In total, 51 PGD children, 52 IVF/ICSI children and 35 NC children underwent neuropsychological testing (WPPSI-III-NL and AWMA). The children's parent(s) and teachers filled in questionnaires evaluating children's executive functioning (Behaviour Rating Inventory of Executive Functions; BRIEF) and socio-emotional development (Child Behaviour Checklist; CBCL and Caregiver-Teacher Report Form; C-TRF).
The mean full-scale intelligence quotient scores (P = 0.426) and performance on the AWMA Listening Span task (P = 0.873) and Spatial Span task (P = 0.458) were comparable between the three groups. Regarding socio-emotional development, the teachers' scores revealed more externalizing (P = 0.011) and total problem (P = 0.019) behaviour in PGD children than for IVF/ICSI children; both groups did not differ significantly from the NC children (P = 0.11). More children (13%) with an affected first-degree family member (mostly parent) were included in the PGD group than in the NC group. Scores in all groups fell within the normal population range and should be considered normal.
LIMITATIONS, REASONS FOR CAUTION: The number of NC children from families with a genetic disorder was relatively small. Furthermore, the fathers' CBCL results were based on small samples.
PGD children show levels of cognitive and socio-emotional development at 5 years that are within the normal range, despite the biopsy involved in PGD and the potential extra psychological burden associated with the presence of a genetic disorder in the family.
STUDY FUNDING/COMPETING INTEREST(S): This study was funded by ZonMw (70-71300-98-106). None of the authors have any competing interests to declare.
NCT02149485.
PGD 是否会增加不良认知和社会情感发展的风险？
与对照组相比，PGD 后出生的儿童的认知和社会情感发展似乎正常。
少数样本量较小的研究表明，PGD 或 PGS 后出生的（前）学龄儿童的认知和社会情感发展似乎与 IVF/ICSI 后出生的儿童以及来自普通人群的自然受孕（NC）儿童相当。
研究设计、大小、持续时间：在这项研究中，我们邀请了 72 名 5 岁的 PGD 儿童、128 名 5 岁的 IVF/ICSI 儿童和 108 名 5 岁的 NC 儿童，他们都来自有遗传疾病的家庭。所有儿童均于 2014 年 1 月至 2016 年 7 月期间受邀参加。
参与者/材料、地点、方法：共有 51 名 PGD 儿童、52 名 IVF/ICSI 儿童和 35 名 NC 儿童接受了神经心理学测试（WPPSI-III-NL 和 AWMA）。儿童的父母和老师填写了评估儿童执行功能（行为评定量表中的执行功能；BRIEF）和社会情感发展（儿童行为检查表；CBCL 和教师报告表；C-TRF）的问卷。
三组儿童的全量表智商得分（P = 0.426）和 AWMA 听力跨度任务（P = 0.873）和空间跨度任务（P = 0.458）的表现相当。关于社会情感发展，教师的评分显示 PGD 儿童的外化（P = 0.011）和总问题（P = 0.019）行为比 IVF/ICSI 儿童多；两组与 NC 儿童均无显著差异（P = 0.11）。在 PGD 组中，有更多受影响一级亲属（主要是父母）的儿童（13%）被纳入，而 NC 组则没有。所有组的分数均在正常人群范围内，应视为正常。
局限性、谨慎的原因：来自有遗传疾病家庭的 NC 儿童数量相对较少。此外，父亲的 CBCL 结果基于小样本。
尽管 PGD 涉及活检，并且家庭中存在遗传疾病可能会带来额外的心理负担，但 PGD 后 5 岁儿童的认知和社会情感发展水平处于正常范围。
研究资金/利益冲突：本研究由 ZonMw（70-71300-98-106）资助。作者均无任何利益冲突。
NCT02149485。
