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他们表现如何?辅助生殖治疗后出生的儿童在学龄期的神经发育结局。

How Are They Doing? Neurodevelopmental Outcomes at School Age of Children Born Following Assisted Reproductive Treatments.

机构信息

Gertner Institute for Epidemiology & Health Policy Research Ltd, Women & Children's Health Research Unit, Tel Hashomer, Israel.

Weinberg Child Development Center, Safra Children's Hospital, 26744Sheba Medical Center, Tel Hashomer, Israel.

出版信息

J Child Neurol. 2021 Mar;36(4):262-271. doi: 10.1177/0883073820967169. Epub 2020 Nov 2.

Abstract

OBJECTIVE

The purpose of this study was to assess major neurodevelopmental aspects of children conceived by assisted reproductive treatments compared to spontaneously conceived children during the early school years.

MATERIAL & METHODS: In this follow-up study, mothers of 358 children born following assisted reproductive treatments and 401 spontaneously-conceived children were interviewed by telephone regarding their children's health and development, when the children were 7-8 years old. The main outcomes were maternal responses to 4 questionnaires: Developmental Coordination Disorder Questionnaire, Short Sensory Profile, Autism Spectrum Screening Questionnaire, and the Attention-deficit hyperactive disorder (ADHD) Child Symptom Inventory-4 subscale. Mothers reported diagnoses of ADHD and autism spectrum disorder.

RESULTS

No significant differences were found between the groups in Developmental Coordination Disorder Questionnaire or Short Sensory Profile scores upon univariate or multivariable analyses. There was a slightly higher but nonsignificant rate of diagnosed ADHD among children in the assisted reproductive treatment group (9.6% vs 5.5%; = .18); on multivariable analysis, a nonsignificant increase in ADHD was also found for assisted reproductive treatment children (hazard ratio 1.45, 95% confidence interval 0.81-2.61). Regarding the Child Symptom Inventory-4 criteria for ADHD among the children who had never been diagnosed, there was also a slightly higher but nonsignificant rate among the assisted reproductive treatments compared to spontaneously-conceived children on univariate (2.4% vs 1.8%; = .50) and multivariable analysis (odds ratio 0.88, 95% confidence interval 0.27-2.86). Autism spectrum disorder diagnosis or Autism Spectrum Screening Questionnaire scores were not significantly different; however, 5 of the 6 children with autism spectrum disorder diagnoses were in the assisted reproductive treatment group.

CONCLUSIONS

Neurodevelopmental measures were similar in both groups, although nonconclusive regarding ADHD and autism spectrum disorder risk. These findings contribute to the knowledge regarding long-term assisted reproductive treatment outcomes.

摘要

目的

本研究旨在评估辅助生殖治疗受孕的儿童与自然受孕儿童在早期学校阶段的主要神经发育方面。

材料与方法

在这项随访研究中,当孩子 7-8 岁时,通过电话采访了 358 名通过辅助生殖治疗出生的儿童和 401 名自然受孕儿童的母亲,了解其子女的健康和发育情况。主要结果是母亲对 4 份问卷的回答:发育协调障碍问卷、简短感觉概况、自闭症谱系筛查问卷和注意力缺陷多动障碍(ADHD)儿童症状清单-4 分量表。母亲报告了 ADHD 和自闭症谱系障碍的诊断。

结果

在单变量或多变量分析中,两组在发育协调障碍问卷或简短感觉概况评分上均无显著差异。辅助生殖治疗组中诊断为 ADHD 的儿童比例略高但无统计学意义(9.6%对 5.5%; =.18);多变量分析也发现辅助生殖治疗儿童的 ADHD 略有增加(风险比 1.45,95%置信区间 0.81-2.61)。对于从未被诊断为 ADHD 的儿童,根据 Child Symptom Inventory-4 标准,辅助生殖治疗组的比例略高但无统计学意义(2.4%对 1.8%; =.50)和多变量分析(比值比 0.88,95%置信区间 0.27-2.86)。自闭症谱系障碍诊断或自闭症谱系筛查问卷评分无显著差异;然而,6 名自闭症谱系障碍诊断儿童中有 5 名在辅助生殖治疗组。

结论

两组的神经发育测量结果相似,但关于 ADHD 和自闭症谱系障碍风险尚无定论。这些发现有助于了解长期辅助生殖治疗的结果。

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