Epidemiology Branch, Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York.
Fertil Steril. 2022 Aug;118(2):349-359. doi: 10.1016/j.fertnstert.2022.04.030. Epub 2022 Jun 10.
To evaluate whether children conceived using assisted reproductive technology (ART) or ovulation induction (OI) have greater cardiometabolic risk than children conceived without treatment.
Clinical assessments in 2018-2019 in the Upstate KIDS cohort.
Clinical sites in New York.
PATIENT(S): Three hundred thirty-three singletons and 226 twins from 448 families.
INTERVENTION(S): Mothers reported their use of fertility treatment and its specific type at baseline and approximately 4 months after delivery. High validity of the self-reported use of ART was previously confirmed. The children were followed up from infancy through 8-10 years of age. A subgroup was invited to participate in clinic visits.
MAIN OUTCOME MEASURE(S): The measurements of blood pressure (BP), arterial stiffness using pulse wave velocity, anthropometric measures, and body fat using bioelectrical impedance analysis were performed (n = 559). The levels of plasma lipids, C-reactive protein, and hemoglobin A1c were measured using blood samples obtained from 263 children.
RESULT(S): The average age of the children was 9.4 years at the time of the clinic visits Approximately 39% were conceived using fertility treatment (18% using ART and 21% using OI). Singletons conceived using fertility treatment (any type or using ART or OI specifically) did not statistically differ in systolic or diastolic BP, heart rate, or pulse wave velocity. Singletons conceived using OI were smaller than singletons conceived without treatment, but the average body mass index of the latter was higher (z-score: 0.41 [SD, 1.24]) than the national norms. Twins conceived using either treatment had lower BP than twins conceived without treatment. However, twins conceived using OI had significantly higher arterial stiffness (0.59; 95% CI, 0.03-1.15 m/s), which was attenuated after accounting for maternal BP (0.29; 95% CI, -0.03 to 0.46 m/s). Twins did not significantly differ in size or fat measures across the groups. The mode of conception was not associated with the levels of lipids, C-reactive protein, or glycosylated hemoglobin.
CONCLUSION(S): Clinical measures at the age of 9 years did not indicate greater cardiometabolic risk in children conceived using ART or OI compared with that in children conceived without treatment.
ClinicalTrials.gov #NCT03106493.
评估采用辅助生殖技术（ART）或排卵诱导（OI）受孕的儿童与未经治疗受孕的儿童相比，其心血管代谢风险是否更大。
2018-2019 年在 Upstate KIDS 队列中的临床评估。
纽约的临床地点。
来自 448 个家庭的 333 名单胎和 226 名双胞胎。
母亲在基线时和分娩后大约 4 个月报告其使用生育治疗及其具体类型。先前已证实自我报告使用 ART 的有效性很高。从婴儿期到 8-10 岁对儿童进行了随访。邀请一部分亚组参加临床就诊。
对 559 名儿童进行血压（BP）、脉搏波速度测量的动脉僵硬度、人体测量学指标和生物电阻抗分析测量的体脂测量。从 263 名儿童获得的血样中测量了血浆脂质、C 反应蛋白和血红蛋白 A1c 的水平。
就诊时儿童的平均年龄为 9.4 岁。大约 39%的儿童采用生育治疗受孕（18%采用 ART，21%采用 OI）。采用任何类型的生育治疗（或专门采用 ART 或 OI）受孕的单胎儿童在收缩压或舒张压、心率或脉搏波速度方面没有统计学差异。采用 OI 受孕的单胎儿童比未经治疗受孕的单胎儿童小，但后者的平均体重指数（z 分数：0.41[标准差，1.24]）高于全国标准。采用任何治疗方法受孕的双胞胎儿童的血压均低于未经治疗受孕的双胞胎儿童。但是，采用 OI 受孕的双胞胎儿童的动脉僵硬度显著更高（0.59；95%置信区间，0.03-1.15 m/s），这一差异在考虑到母亲的血压后减弱（0.29；95%置信区间，-0.03 至 0.46 m/s）。各组之间双胞胎的体型或脂肪指标没有显著差异。受孕方式与脂质、C 反应蛋白或糖化血红蛋白水平无关。
9 岁时的临床指标并未表明采用 ART 或 OI 受孕的儿童与未经治疗受孕的儿童相比，其心血管代谢风险更高。
ClinicalTrials.gov #NCT03106493。
