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母亲孕前体重指数对体外受精/胞浆内单精子注射后出生的单胎儿认知和代谢特征的影响。

Impact of maternal prepregnancy body mass index on cognitive and metabolic profiles of singletons born after in vitro fertilization/intracytoplasmic sperm injection.

机构信息

Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Zhejiang, People's Republic of China.

Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Zhejiang, People's Republic of China.

出版信息

Fertil Steril. 2019 Dec;112(6):1094-1102.e2. doi: 10.1016/j.fertnstert.2019.08.054.

Abstract

OBJECTIVE

To evaluate the effect of elevated maternal prepregnancy body mass index (BMI) on intelligence and growth of singletons after in vitro fertilization (IVF) with or without intracytoplasmic sperm injection (ICSI).

DESIGN

Cohort study.

SETTING

University hospital.

PATIENT(S): Singletons born to infertile couples who underwent an autologous IVF/ICSI cycle from 2002 to 2012 and were followed up with at the age of 3-6 years from 2009 to 2017.

INTERVENTIONS(S): We compared the health of offspring born to overweight/obese women and normal weight women through assisted reproductive technology (ART).

MAIN OUTCOME MEASURE(S): Age- and sex-specific BMI z-scores, verbal intelligence quotient (VIQ), performance intelligence quotient (PIQ), and full intelligence quotient (FIQ).

RESULT(S): After adjusting for confounders, obese women were more likely than normal-BMI women to have obese children (20.0% vs. 5.1%), and overweight women had increased risks of having overweight children (13.6% vs. 8.2%) or obese children (10.1% vs. 5.1%) compared with normal-BMI women. Maternal prepregnancy BMI had a weakly negative effect on estimated IQ of children, but after adjusting for parental educational level, the IQ scores of offspring were similar between groups. However, after adjusting for confounders, offspring of obese women showed increased prevalence of intellectual disability (IQ <80) in VIQ (16.9% vs. 8.5%) and FIQ (10.8% vs. 3.9%) compared with normal-BMI women.

CONCLUSION(S): Maternal prepregnancy obesity is associated with increased risks for obesity and overweight at early ages in offspring conceived through IVF/ICSI and may also affect the risk of intellectual disability of offspring. Overall, we suggest that weight management is essential for women before entering an IVF/ICSI cycle for ensuring long-term child health.

摘要

目的

评估体外受精(IVF)或卵胞浆内单精子注射(ICSI)后,孕妇孕前体重指数(BMI)升高对单胎婴儿智力和生长的影响。

设计

队列研究。

地点

大学医院。

患者

2002 年至 2012 年期间接受自体 IVF/ICSI 周期的不孕夫妇所生的单胎婴儿,并于 2009 年至 2017 年期间在 3-6 岁时进行随访。

干预

我们通过辅助生殖技术(ART)比较了超重/肥胖女性和正常体重女性所生后代的健康状况。

主要观察指标

年龄和性别特异性 BMI z 评分、言语智商(VIQ)、表现智商(PIQ)和全智商(FIQ)。

结果

在调整混杂因素后,肥胖女性所生肥胖儿童的比例(20.0%比 5.1%)高于正常 BMI 女性,超重女性所生超重儿童(13.6%比 8.2%)或肥胖儿童(10.1%比 5.1%)的风险高于正常 BMI 女性。孕妇孕前 BMI 对儿童估计智商有较弱的负向影响,但在调整父母教育水平后,各组间的子女智商评分相似。然而,在调整混杂因素后,与正常 BMI 女性相比,肥胖女性的子女在 VIQ(16.9%比 8.5%)和 FIQ(10.8%比 3.9%)中智力残疾(智商<80)的患病率更高。

结论

体外受精/卵胞浆内单精子注射受孕的婴儿,母亲孕前肥胖与婴儿早期肥胖和超重的风险增加相关,也可能影响婴儿智力残疾的风险。总的来说,我们建议在进入 IVF/ICSI 周期前,女性应进行体重管理,以确保儿童的长期健康。

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