Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.
Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Fertil Steril. 2020 May;113(5):1014-1023. doi: 10.1016/j.fertnstert.2020.01.012.
To assess whether academic achievement among children conceived following fertility treatment is different from that of children born to fertile women while also considering the underlying infertility.
Population-based cohort study.
Denmark.
PATIENT(S): The study population consisted of all 154,536 firstborn, live-born, singleton children in Denmark between 1995 and 2000 who completed their ninth grade with an examination.
INTERVENTION(S): The Danish Infertility Cohort was used to identify children conceived after fertility treatment (n = 10,099), and information on mean school marks was obtained from Statistics Denmark.
MAIN OUTCOME MEASURE(S): Linear regression models were used to estimate mean differences (MDs) and 95% confidence intervals (CIs). Multiple logistic regression models were used to estimate odds ratios (OR) and 95% CI of not passing the ninth-grade examination.
The crude overall mean marks for children conceived after the various fertility treatment procedures were in general higher than in children born to fertile women. However, after adjustment for potential confounders, the overall mean marks were statistically significantly lower for children conceived after the various fertility treatment procedures (e.g., any fertility treatment: MD -0.13; 95% CI -0.18, -0.08) compared with children born to fertile women. Further, children conceived after any fertility treatment had a statistically significant lower crude likelihood of not passing the ninth-grade examination (OR 0.66; 95% CI 0.53, 0.81) compared with children born to fertile women, whereas no difference was observed in the confounder adjusted analyses (OR 1.15; 95% CI 0.89, 1.49). When children born to women requiring fertility assistance but without fertility treatment in the index pregnancy were used as a reference group, no differences in the adjusted overall mean marks and the likelihood of not passing the ninth grade with an examination were observed.
Our findings indicate that fertility treatment per se is not associated with lower school marks and the likelihood of not passing the ninth grade with an examination. Hence, we suggest that factors related to both fertility problems and cognitive development may more likely explain the slightly lower academic performance (i.e., modest lower mean marks) among children conceived after fertility treatment.
评估接受生育治疗后受孕的儿童与自然受孕的儿童在学业成绩上是否存在差异，同时也考虑到潜在的不孕因素。
基于人群的队列研究。
丹麦。
本研究的研究对象为 1995 年至 2000 年间在丹麦出生的 154536 名第一胎、活产、单胎儿童，这些儿童在完成九年级学业时参加了考试。
丹麦不孕队列用于识别接受生育治疗后受孕的儿童（n=10099），并从丹麦统计局获得有关平均学校成绩的信息。
采用线性回归模型估计平均差异（MD）和 95%置信区间（CI）。采用多因素逻辑回归模型估计未通过九年级考试的几率比（OR）和 95%CI。
接受各种生育治疗的儿童的原始总体平均成绩普遍高于自然受孕的儿童。然而，在调整了潜在混杂因素后，与自然受孕的儿童相比，接受各种生育治疗的儿童的总体平均成绩在统计学上显著较低（例如，任何生育治疗：MD-0.13；95%CI-0.18，-0.08）。此外，与自然受孕的儿童相比，接受任何生育治疗的儿童未通过九年级考试的几率明显较低（OR 0.66；95%CI 0.53，0.81），而在调整混杂因素的分析中未观察到差异（OR 1.15；95%CI 0.89，1.49）。当以索引妊娠中无需生育辅助且未接受生育治疗的妇女所生的儿童为参考组时，调整后的总体平均成绩和未通过九年级考试的几率均无差异。
我们的研究结果表明，生育治疗本身与较低的学习成绩和未通过九年级考试的几率无关。因此，我们认为，与生育问题和认知发展相关的因素可能更能解释接受生育治疗后受孕的儿童的学业成绩略低（即平均分数略低）。
