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胚胎植入前遗传学检测后的儿童健康。

Child health after preimplantation genetic testing.

机构信息

Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne Victoria, Australia; Department of Paediatrics, University of Melbourne, Melbourne Victoria, Australia.

Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne Victoria, Australia; Department of Paediatrics, University of Melbourne, Melbourne Victoria, Australia.

出版信息

Reprod Biomed Online. 2021 Mar;42(3):609-619. doi: 10.1016/j.rbmo.2020.11.014. Epub 2020 Nov 26.

Abstract

RESEARCH QUESTION

Despite the increasing use of preimplantation genetic testing (PGT) for aneuploidy and monogenic diseases, for children conceived using PGT there is limited follow-up beyond 2 years of age. This study examined the health, well-being and development of school-aged children (5-8 years old) conceived following PGT.

DESIGN

Retrospective cohort study of children conceived after IVF with PGT (exposed cohort) and children conceived after IVF without PGT (unexposed cohort) at two IVF clinics in Melbourne, born between 2000 and 2008, recruited with a 1:2 ratio. Mothers of the children completed a questionnaire asking child-specific questions regarding health and well-being, mental health, development, educational achievement and family-specific questions regarding family functioning and parent-child attachment.

RESULTS

A total of 155 participants were recruited to the PGT cohort and 303 participants to the IVF-only cohort. There were no differences between the two cohorts with regards to maternal characteristics, birth defect frequency and pregnancy characteristics, apart from delivery by Caesarean section, which was more frequent in PGT singletons (55%) compared with IVF-only singletons (36%). While no significant differences between the PGT and IVF-only cohorts were found for the majority of general health and psychological scales, there were differences when compared with population data. Children in the exposed cohort appeared to have more positive outcomes in many of the measures.

CONCLUSION

The data from this study suggest that PGT does not cause adverse outcomes in children. However, the nature (self-report) and small sample size of the study must be taken into consideration when interpreting the data.

摘要

研究问题

尽管胚胎植入前遗传学检测(PGT)在非整倍体和单基因疾病中的应用越来越多,但对于使用 PGT 受孕的儿童,其随访时间通常不超过 2 岁。本研究旨在调查接受 PGT 受孕的儿童在 2 岁后健康、幸福和发育状况。

设计

这项回顾性队列研究以墨尔本的两家试管婴儿诊所中接受 PGT (暴露组)和未接受 PGT (对照组)的试管婴儿出生的儿童为研究对象,招募时按照 1:2 的比例进行。这些儿童的母亲填写了一份问卷,问卷内容包括儿童健康和幸福、心理健康、发育、教育成就以及家庭功能和亲子依恋等方面的特定问题。

结果

共有 155 名接受 PGT 的儿童和 303 名接受单纯 IVF 的儿童被纳入研究。两组在母亲特征、出生缺陷频率和妊娠特征方面无差异,但在剖宫产分娩方面存在差异,PGT 组单胎(55%)高于对照组单胎(36%)。除了与人群数据相比,PGT 组和对照组在大多数一般健康和心理量表方面无显著差异。暴露组的儿童在许多指标中表现出更好的结果。

结论

本研究数据表明 PGT 不会对儿童造成不良影响。但必须考虑到研究的性质(自我报告)和样本量小的问题,以正确解读研究数据。

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