Lefebvre Tiphaine, Flamant Cyril, Olivier Marion, Gascoin Géraldine, Bouet Pierre-Emmanuel, Roze Jean-Christophe, Barrière Paul, Fréour Thomas, Muller Jean-Baptiste
Department of Biology and Reproductive Medicine, University Hospital of Nantes, Nantes, France.
Faculty of Medicine, University of Nantes, Nantes, France.
Front Pediatr. 2023 Jun 19;11:1123183. doi: 10.3389/fped.2023.1123183. eCollection 2023.
Assisted reproductive technology (ART) increases the rate of preterm births, though few studies have analyzed outcomes for these infants. No data are available on 4-year-old children born prematurely after ART. The objective was to investigate whether ART affect the neurodevelopmental outcomes at 4 years in preterm infants born before 34 weeks of gestational age (GA).
A total of 166 ART and 679 naturally conceived preterm infants born before 34 weeks GA between 2013 and 2015 enrolled in the Loire Infant Follow-up Team were included. Neurodevelopment was assessed at 4 years using the age and stage questionnaire (ASQ) and the need for therapy services. The association between the socio-economic and perinatal characteristics and non-optimal neurodevelopment at 4 years was estimated. After adjustment, the ART preterm group remained significantly associated with a lower risk of having at least two domains in difficulty at ASQ: adjusted odds ratio (aOR) 0.34, 95% confidence interval (CI) (0.13-0.88), = 0.027. The factors independently associated with non-optimal neurodevelopment at 4 years were male gender, low socio-economic level, and 25-30 weeks of GA at birth. The need for therapy services was similar between groups ( = 0.079). The long-term neurodevelopmental outcomes of preterm children born after ART are very similar, or even better than that of the spontaneously conceived children.
辅助生殖技术（ART）会增加早产率，不过很少有研究分析这些婴儿的结局。目前尚无关于ART后早产的4岁儿童的数据。本研究的目的是调查ART是否会影响孕龄（GA）小于34周的早产婴儿4岁时的神经发育结局。
纳入了2013年至2015年间卢瓦尔河婴儿随访团队登记的166例ART早产婴儿和679例自然受孕的GA小于34周的早产婴儿。使用年龄与发育进程问卷（ASQ）和治疗服务需求在4岁时评估神经发育情况。评估了社会经济和围产期特征与4岁时神经发育不理想之间的关联。经过校正后，ART早产组与ASQ中至少有两个领域存在困难的较低风险仍显著相关：校正比值比（aOR）为0.34，95%置信区间（CI）为（0.13 - 0.88），P = 0.027。与4岁时神经发育不理想独立相关的因素为男性性别、社会经济水平低以及出生时GA为25 - 30周。两组之间治疗服务需求相似（P = 0.079）。ART后出生的早产儿童的长期神经发育结局与自然受孕儿童非常相似，甚至更好。
