Miller Virginia, Diamond Michael P, Hansen Karl R, Steiner Anne Z, Cedars Marcelle, Legro Richard S, Krawetz Stephen A, Coutifaris Christos, Huang Hao, Santoro Nanette, Zhang Heping
Division of Population Health Sciences, University of Alaska, Anchorage, AK 99508, USA.
Department of Obstetrics and Gynecology, Augusta University, Augusta, GA 30912, USA.
Hum Reprod Open. 2020 Apr 13;2020(2):hoaa010. doi: 10.1093/hropen/hoaa010. eCollection 2020.
What are the psychosocial and financial issues experienced among families with children 2-12 years of age conceived by ART?
Our results suggest that families with children, 2-12 years of age, conceived via ART are doing well, although impacts were identified on parents of twins and higher-order multiples.
Multiple births have been associated with higher morbidity and mortality of children, as well as financial costs to families and society.
This study was an assessment of familial response to birth of singletons, twins and higher order multiples at child's ages of 2-12.
PARTICIPANTS/MATERIALS SETTING METHODS: Semi-structured interviews and surveys were conducted with mothers ( = 348) and fathers ( = 338) of singletons, twins and higher-order multiple gestations who received fertility services.
No significant differences were observed between the groups in domains of primary caregiving or parental separation/divorce. Impacts were identified on parent's ability to maintain employment. The revised 15-item scores of the Impact on Family Scale were significantly lower, reflecting more negative impacts, among families with twins (beta = -2.6, 95% confidence interval (CI), -4.7, -0.5, = 0.014) and multiples (beta = -7.4, 95% CI, -10.4, -4.5, < 0.001) than among families with singletons. Similarly, the Parenting Stress Index total scores were significantly lower among families with twins and multiples, indicating greater levels of stress, when compared to those with singletons. In addition, the Beck Depression Inventory total score were significantly higher for twins and multiples, and the Child Behaviour Checklist for ages 1.5-5 total problem score was significantly higher for twins when compared to singletons.
The study was limited to families who received fertility treatment and constitutes a population that was well educated and had higher incomes. Additionally, interview data was self-reported.
STUDY FUNDING/COMPETING INTERESTS: This work was supported by National Institutes of Health (NIH)/Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) U10 HD39005 (to M.P.D.), U10 HD077680 (to K.R.H.), U10 HD077844 (to A.Z.), U10 HD077841 (to M.C.), U10 HD38992 (to R.S.L.), U10 HD27049 (to C.C.), U10 HD055925 (to H.Z.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NICHD or NIH.Dr Virginia Miller-no conflicts; Dr Michael P. Diamond-NIH Funding, AbbVie, Bayer and ObsEva Funding; Board of Directors and Stockholder for Advanced Reproductive Care; Dr Karl R. Hansen-Yale University/Reproductive Medicine Network/NICHD, Roche Diagnostics and Ferring International Pharmascience Center US funding; Dr Anne Steiner-NIH Funding; Dr Marcelle I. Cedars-no conflicts; Dr Richard Legro-consultant for Ogeda, Millendo, Kindex and Bayer; Ferring and Astra Zeneca funding; Dr Stephen A. Krawetz-no conflicts; Dr Christos Coutifaris-NIH Funding; Dr Hao Huang-no conflicts; Dr Nanette Santoro-no conflicts; Dr Heping Zhang-NIH Funding.
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通过辅助生殖技术（ART）受孕的2至12岁儿童家庭经历了哪些心理社会和经济问题？
我们的结果表明，通过ART受孕的2至12岁儿童家庭情况良好，不过发现双胞胎及高阶多胞胎的父母受到了影响。
多胎妊娠与儿童更高的发病率和死亡率相关，也给家庭和社会带来经济成本。
研究设计、规模、持续时间：本研究评估了儿童2至12岁时，家庭对单胎、双胞胎及高阶多胞胎出生的反应。
参与者/材料、环境、方法：对接受生育服务的单胎、双胞胎及高阶多胞胎妊娠的母亲（n = 348）和父亲（n = 338）进行了半结构化访谈和调查。
在主要照料领域或父母分居/离婚方面，各组之间未观察到显著差异。发现对父母维持就业的能力有影响。与单胎家庭相比，双胞胎家庭（β = -2.6，95%置信区间（CI），-4.7，-0.5，P = 0.014）和多胞胎家庭（β = -7.4，95% CI，-10.4，-4.5，P < 0.001）中家庭影响量表修订后的15项得分显著更低，反映出更多负面影响。同样，与单胎家庭相比，双胞胎和多胞胎家庭中育儿压力指数总分显著更低，表明压力水平更高。此外，双胞胎和多胞胎的贝克抑郁量表总分显著更高，与单胎相比，双胞胎1.5至5岁儿童行为检查表的总问题得分显著更高。
局限性、谨慎原因：该研究仅限于接受生育治疗的家庭，且研究对象是受过良好教育、收入较高的人群。此外，访谈数据为自我报告。
研究资金/利益冲突：本研究得到美国国立卫生研究院（NIH）/尤妮斯·肯尼迪·施赖弗国立儿童健康与人类发展研究所（NICHD）U10 HD39005（资助M.P.D.）、U10 HD077680（资助K.R.H.）、U10 HD077844（资助A.Z.）、U10 HD077841（资助M.C.）、U10 HD38992（资助R.S.L.）、U10 HD27049（资助C.C.）、U10 HD055925（资助H.Z.）的支持。内容完全由作者负责，不一定代表NICHD或NIH的官方观点。弗吉尼亚·米勒博士无利益冲突；迈克尔·P·戴蒙德博士——NIH资助、艾伯维、拜耳和ObsEva资助；高级生殖护理董事会成员及股东；卡尔·R·汉森博士——耶鲁大学/生殖医学网络/NICHD、罗氏诊断和美国费林国际制药科学中心资助；安妮·施泰纳博士——NIH资助；玛塞勒·I·西德斯博士无利益冲突；理查德·莱格罗博士——奥格达、米伦多、金德克斯和拜耳的顾问；费林和阿斯利康资助；斯蒂芬·A·克拉韦茨博士无利益冲突；克里斯托斯·库蒂法里斯博士——NIH资助；郝黄博士无利益冲突；纳内特·桑托罗博士无利益冲突；和平·张博士——NIH资助。
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