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辅助生殖技术与子代神经发育结局:华东地区前瞻性出生队列研究。

Assisted reproductive technology and neurodevelopmental outcomes in offspring: a prospective birth cohort study in East China.

机构信息

International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; International Peace Maternity and Child Health Hospital of China Welfare Institution, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.

International Peace Maternity and Child Health Hospital of China Welfare Institution, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

出版信息

Reprod Biomed Online. 2023 Jun;46(6):983-994. doi: 10.1016/j.rbmo.2023.02.006. Epub 2023 Feb 21.

Abstract

RESEARCH QUESTION

Is ART associated with adverse neurodevelopmental outcome in 12-month-old offspring compared with those conceived through natural conception?

DESIGN

In this prospective cohort study, 488 infertile women undergoing ART and 1397 women with natural conception were recruited and followed until their offspring were 12 months old. The primary outcome was the neurodevelopment in the offspring. The association between exposure to ART and Gesell developmental scale scores was investigated using multiple linear regression models after adjusting for confounders. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were used to verify the results.

RESULTS

In total, 18 (3.7%) and 40 (2.9%) children in the ART and natural conception groups, respectively, had been diagnosed with neurodevelopmental delay at 12 months of age. It was found that gross motor, adaptive behaviour, language and total development quotient scores were comparable between the groups. Following multivariate linear regression and IPTW, social behaviour development quotient scores were found to be slightly higher in the ART group than the natural conception group. Higher social behaviour development quotient scores in the ART group were also observed in the male and the singleton subgroups.

CONCLUSIONS

At 12 months, offspring born after ART appeared to have similar motor, language and adaptive behaviour skills, and total development quotient scores, to those born after natural conception. However, social behaviour development in 12-month-old infants was slightly higher in those conceived using ART than in naturally conceived offspring, especially in male or singleton infants. These findings may provide new information in evaluating the potential benefits and risks of ART.

摘要

研究问题

与自然受孕相比,ART 是否会导致 12 个月大的后代出现不良神经发育结局?

设计

在这项前瞻性队列研究中,招募了 488 名接受 ART 的不孕妇女和 1397 名自然受孕的妇女,并随访至其子女 12 个月大。主要结局是后代的神经发育情况。在调整混杂因素后,使用多元线性回归模型研究了暴露于 ART 与 Gesell 发育量表评分之间的关系。采用倾向评分匹配(PSM)和逆概率处理加权(IPTW)来验证结果。

结果

在 ART 组和自然受孕组中,分别有 18 名(3.7%)和 40 名(2.9%)儿童在 12 个月时被诊断为神经发育迟缓。结果发现,两组的粗大运动、适应行为、语言和总发育商评分相当。经过多元线性回归和 IPTW 后,发现 ART 组的社会行为发育商评分略高于自然受孕组。在男性和单胎亚组中,ART 组的社会行为发育商评分也更高。

结论

在 12 个月时,接受 ART 出生的后代似乎具有与自然受孕出生的后代相似的运动、语言和适应行为技能以及总发育商评分。然而,接受 ART 受孕的 12 个月大婴儿的社会行为发育略高于自然受孕的婴儿,尤其是在男性或单胎婴儿中。这些发现可能为评估 ART 的潜在益处和风险提供新的信息。

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