Palma Maria, Fitzsimons Emla, Patalay Praveetha, Goisis Alice
Centre for Longitudinal Studies, Social Research Institute, University College London, London, UK.
Lifelong Health and Ageing Unit, Faculty of Population Health Sciences, University College London, London, UK.
J Child Psychol Psychiatry. 2024 Mar;65(3):275-284. doi: 10.1111/jcpp.13877. Epub 2023 Aug 10.
The number and proportion of children conceived through medically assisted reproduction (MAR) is steadily increasing yet the evidence on their mental health in adolescence is inconclusive. Two main mechanisms with opposite effects can explain differences in mental health outcomes by conception mode: while more advantaged parental characteristics could positively influence it, higher parental stress could have a negative influence.
Linear and logistic estimations on a longitudinal population-based birth cohort study of 9,897 individuals to investigate whether adolescents conceived through MAR are more likely than naturally conceived (NC) children to experience mental health problems at age 17, as reported by adolescents themselves and their parents. We test whether this association is confounded and/or mediated by parental background characteristics collected when the cohort member was around 9 months old (maternal age, maternal education level, ethnicity, income quintile), family structure variables measured in adolescence (number of siblings in the household at age 15, parental household structure at age 14) or maternal distress at age 14.
Children conceived naturally and through MAR self-reported similar mental health outcomes. The only differences between MAR and NC adolescents are in the parental reports, with parents who conceived through MAR reporting their children had 3.82 (95% CI: 1.140 to 11.54) and 2.35 (95% CI: 1.145 to 4.838) higher odds of falling within the high category of SDQ total difficulties and emotional symptoms scales, respectively. The results did not change on adjustment for mediators, such as maternal distress, number of siblings in the household and parental household structure.
The results reveal a lack of or small differences in MAR adolescents' mental health outcomes compared to children who were conceived naturally. While the results based on the parental reports could suggest that MAR adolescents are at higher risk of suffering from mental health problems, the differences are small and not supported by adolescents' own reports. The difference between MAR and NC adolescent's parental report might reflect differences in parental concern, their relationship or closeness and can help to reconcile the mixed findings of previous studies.
通过医学辅助生殖（MAR）受孕的儿童数量及比例在稳步上升，但其青春期心理健康状况的证据尚无定论。受孕方式导致心理健康结果存在差异可由两种作用相反的主要机制来解释：一方面，更优越的父母特征可能对其产生积极影响；另一方面，更高的父母压力可能产生负面影响。
对一项基于人群的纵向出生队列研究中的9897名个体进行线性和逻辑估计，以调查通过MAR受孕的青少年在17岁时是否比自然受孕（NC）儿童更易出现心理健康问题，这由青少年及其父母报告。我们检验这种关联是否会受到队列成员约9个月大时收集的父母背景特征（母亲年龄、母亲教育水平、种族、收入五分位数）、青少年时期测量的家庭结构变量（15岁时家庭中的兄弟姐妹数量、14岁时父母的家庭结构）或14岁时母亲的困扰所混淆和/或介导。
自然受孕和通过MAR受孕的儿童自我报告的心理健康结果相似。MAR青少年和NC青少年之间唯一的差异在于父母的报告，通过MAR受孕的父母报告其孩子在SDQ总困难量表和情绪症状量表中处于高分组的几率分别高出3.82（95%CI：1.140至11.54）和2.35（95%CI：1.145至4.838）。在对诸如母亲困扰、家庭中的兄弟姐妹数量和父母家庭结构等中介因素进行调整后，结果并未改变。
结果显示，与自然受孕的儿童相比，MAR青少年的心理健康结果缺乏差异或差异较小。虽然基于父母报告的结果可能表明MAR青少年患心理健康问题的风险更高，但差异较小且未得到青少年自身报告的支持。MAR青少年和NC青少年的父母报告之间的差异可能反映了父母关注程度、他们的关系或亲密度的差异，有助于调和先前研究的混合结果。
