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不孕治疗与子代的长期神经发育不良。

Infertility Treatments and Long-Term Neurologic Morbidity of the Offspring.

机构信息

Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Fertility and IVF Unit, Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

出版信息

Am J Perinatol. 2019 Jul;36(9):949-954. doi: 10.1055/s-0038-1675159. Epub 2018 Nov 16.

Abstract

OBJECTIVE

To determine the risk of long-term neurologic morbidity among children (up to 18 years) born following in vitro fertilization (IVF) or ovulation induction (OI) treatments as compared with spontaneously conceived.

STUDY DESIGN

A population-based cohort analysis was performed, including data from the perinatal computerized database on all singleton infants born at the Soroka University Medical Center (SUMC) between the years 1991 and 2014. This perinatal database was linked and cross-matched with the SUMC computerized dataset of all pediatric hospitalizations.

RESULTS

Neurologic morbidity was significantly more common in IVF (3.7%) and OI (4.1%) offspring as compared with those following spontaneous pregnancies (3.1%;  = 0.017). In particular, attention deficit/hyperactivity disorders and headaches were more common in the OI group and sleep disorders in the IVF group, whereas autism and cerebral palsy were comparable between the groups. In the Weibull multivariable analysis, while controlling for maternal age, preterm delivery, birthweight centile, maternal diabetes, and hypertensive disorders, IVF (adjusted hazard ratio [HR]: 1.40; 95% confidence interval [CI]: 1.14-1.71;  = 0.001), but not OI (adjusted HR: 1.17' 95% CI: 0.92-1.48;  = 0.196), was noted as an independent risk factor for long-term pediatric neurologic morbidity.

CONCLUSION

IVF offspring appear to be at an increased risk of long-term neurologic morbidity up to 18 years of age.

摘要

目的

比较体外受精(IVF)或排卵诱导(OI)治疗后出生的儿童(直至 18 岁)与自然受孕儿童的长期神经系统发病率风险。

研究设计

进行了一项基于人群的队列分析,包括 1991 年至 2014 年期间在索罗卡大学医学中心(SUMC)出生的所有单胎婴儿的围产儿计算机数据库中的数据。该围产儿数据库与 SUMC 所有儿科住院患者的计算机数据集进行了链接和交叉匹配。

结果

与自然妊娠后代(3.1%)相比,IVF(3.7%)和 OI(4.1%)后代的神经系统发病率显著更高(=0.017)。特别是,OI 组中注意力缺陷/多动障碍和头痛更为常见,而 IVF 组中睡眠障碍更为常见,而自闭症和脑瘫在两组之间相似。在威布尔多变量分析中,在控制了母亲年龄、早产、出生体重百分位、母亲糖尿病和高血压疾病后,IVF(调整后的危险比 [HR]:1.40;95%置信区间 [CI]:1.14-1.71;=0.001),但不是 OI(调整后的 HR:1.17'95%CI:0.92-1.48;=0.196),被认为是长期儿科神经系统发病率的独立危险因素。

结论

IVF 后代似乎在 18 岁之前存在长期神经系统发病率增加的风险。

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