母亲不孕治疗与儿童神经发育的关联：来自日本宫城和岩手县东北医学巨大学术数据库母婴三代队列研究的结果

Association between maternal infertility treatment and child neurodevelopment: findings from the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study in Miyagi and Iwate Prefectures, Japan.

机构信息

Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan.

Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.

出版信息

BMJ Open. 2022 Jun 7;12(6):e060944. doi: 10.1136/bmjopen-2022-060944.

DOI:10.1136/bmjopen-2022-060944

PMID:35672073

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9174802/

Abstract

OBJECTIVES

This study aimed to examine the association between infertility treatment and neurodevelopment in children at 2 and 3.5 years of age.

DESIGN

Prospective cohort study.

SETTING AND PARTICIPANTS

The study population consisted of mother-child pairs who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study in Miyagi and Iwate Prefectures, Japan. Pregnant women were recruited in obstetric clinics or hospitals and their children were followed up by the questionnaire.

OUTCOME MEASURES

The children's neurodevelopmental outcomes were assessed at 2 and 3.5 years of age using the Ages and Stages Questionnaire, third edition (ASQ-3), which consists of questions on five developmental domains. We performed a multivariate logistic regression analysis of the association between infertility treatment (including ovulation induction (OI), artificial insemination with husband's sperm (AIH) and assisted reproductive technology (ART)) and the clinical range of ASQ-3.

RESULTS

Of 9655 mother-child pairs, 273 (2.8%) and 487 (5.0%) were conceived through OI/AIH and ART, respectively. The odds of having developmental delays at 2 years of age were higher in children conceived through OI/AIH (OR, 1.36; 95% CI 1.00 to 1.85) and ART (OR, 1.36; 95% CI 1.07 to 1.72) than in those conceived naturally. Additionally, OI/AIH and ART were significantly associated with communication (OR, 1.93; 95% CI 1.25 to 2.98) and gross motor (OR, 1.50; 95% CI 1.08 to 2.09) delays, respectively. There were no statistically significant differences in the odds of having developmental delays at 3.5 years of age in children conceived through OI/AIH (OR, 1.13; 95% CI 0.79 to 1.61) and ART (OR, 1.03; 95% CI 0.78 to 1.37).

CONCLUSION

In this study, we found a significant association between infertility treatment and children's neurodevelopment at 2 years of age, whereas no statistically significant differences were found at 3.5 years of age.

摘要

目的

本研究旨在探讨不孕治疗与儿童 2 岁和 3.5 岁时神经发育的关系。

设计

前瞻性队列研究。

地点和参与者

该研究人群包括参加日本宫城县和岩手县东北医科大学母婴三代队列研究的母婴对。孕妇在妇产科诊所或医院招募，通过问卷调查对其子女进行随访。

结局测量

采用年龄和阶段问卷（ASQ-3）评估儿童在 2 岁和 3.5 岁时的神经发育结局，该问卷包括五个发育领域的问题。我们对不孕治疗（包括促排卵（OI）、夫精人工授精（AIH）和辅助生殖技术（ART））与 ASQ-3 临床范围之间的关系进行了多变量逻辑回归分析。

结果

在 9655 对母婴中，273 对（2.8%）和 487 对（5.0%）通过 OI/AIH 和 ART 受孕。与自然受孕的儿童相比，OI/AIH（OR，1.36；95%CI，1.00 至 1.85）和 ART（OR，1.36；95%CI，1.07 至 1.72）受孕的儿童在 2 岁时发育迟缓的可能性更高。此外，OI/AIH 和 ART 与沟通（OR，1.93；95%CI，1.25 至 2.98）和粗大运动（OR，1.50；95%CI，1.08 至 2.09）延迟均显著相关。OI/AIH（OR，1.13；95%CI，0.79 至 1.61）和 ART（OR，1.03；95%CI，0.78 至 1.37）受孕的儿童在 3.5 岁时发育迟缓的可能性无统计学差异。