Swedish Institute of Social Research, Stockholm University, Stockholm, Sweden.
ROCKWOOL Foundation, København K, Denmark.
Eur J Public Health. 2023 Dec 9;33(6):1020-1026. doi: 10.1093/eurpub/ckad123.
Previous research has indicated that children conceived through medically assisted reproduction (MAR) generally have cognitive outcomes comparable to or better than naturally conceived children. However, previous studies have been limited in their ability to examine this relationship at a population level and consider variations across different types of MAR.
This study utilizes data from all live births in Denmark between 2006 and 2009 (n = 259 608), including a subset of births resulting from MAR conceptions (n = 13 566). The dependent variable is the standardized test scores obtained in the second and third grades of primary schools. A comparison is made between the test scores of children spontaneously conceived (SC) and those conceived through intrauterine insemination (IUI) and assisted reproductive technologies (ART). Ordinary least squares regressions are employed, with a baseline model adjusted only for birth year, as well as models that additionally account for conception-related confounders and sociodemographic family characteristics.
In the baseline analysis, ART- and IUI-conceived children displayed better test scores compared with their SC peers. However, after adjusting for relevant factors, ART-conceived children performed worse than SC peers, while IUI-conceived children performed equally well as SC peers and better than ART-conceived children.
These results likely reflect differences in the selection process of potential parents into the type of MAR, as well as the consequences of variations in fecundability. Nevertheless, the differences observed across conception types were overshadowed by test score disparities in socioeconomic background.
先前的研究表明，通过医学辅助生殖（MAR）受孕的儿童的认知结果通常与自然受孕的儿童相当或更好。然而，先前的研究在从人群层面上检验这种关系以及考虑不同类型 MAR 之间的差异方面能力有限。
本研究利用了 2006 年至 2009 年期间丹麦所有活产儿的数据（n=259608），其中包括一部分 MAR 受孕的出生儿（n=13566）。因变量是小学二、三年级的标准化考试成绩。对自然受孕（SC）儿童与通过宫内授精（IUI）和辅助生殖技术（ART）受孕的儿童的考试成绩进行比较。采用普通最小二乘法回归，基础模型仅调整了出生年份，以及额外考虑了受孕相关混杂因素和社会人口家庭特征的模型。
在基础分析中，ART 和 IUI 受孕的儿童的考试成绩优于其 SC 同龄人。然而，在调整了相关因素后，ART 受孕的儿童的表现不如 SC 同龄人，而 IUI 受孕的儿童的表现与 SC 同龄人相当，且优于 ART 受孕的儿童。
这些结果可能反映了潜在父母在 MAR 类型选择过程中的差异，以及生育能力差异的后果。然而，在受孕类型之间观察到的差异被社会经济背景测试成绩差异所掩盖。
