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辅助生殖技术:儿童期和成人疾病胎儿编程中的新因素?

Assisted Reproductive Technologies: A New Player in the Foetal Programming of Childhood and Adult Diseases?

作者信息

Faa Gavino, Manchia Mirko, Fanos Vassilios

机构信息

Department of Medical Sciences and Public Health, University of Cagliari, Monserrato, 09042 Cagliari, Italy.

Department of Biology, College of Science and Technology, Temple University, Philadelphia, PA 19122, USA.

出版信息

Pediatr Rep. 2024 Apr 26;16(2):329-338. doi: 10.3390/pediatric16020029.

Abstract

Assisted reproductive technology (ART) is an emerging field in medicine that incorporates complex procedures and has profound ethical, moral, social, religious, and economic implications not just for the individuals who have access to this method but also for society. In this narrative review, we summarise multiple aspects of ART procedures and the possible consequences on the mother and newborn. Moreover, we provide an overview of the possible long-term consequences of ART procedures on the health of newborns, although longitudinal evidence is particularly scant. Users should be informed that ART procedures are not risk-free to prepare them for the possible negative outcomes that may occur in the perinatal period or even in childhood and adulthood. Indeed, risk estimates point to increased liability for major nonchromosomal birth defects; cardiovascular, musculoskeletal, and urogenital (in male newborns) defects; and any other birth defects. Less certainty is present for the risk of neuropsychiatric sequelae in children conceived through ART. Thus, its application should be accompanied by adequate counselling and psychological support, possibly integrated into specific multidisciplinary clinical programmes.

摘要

辅助生殖技术(ART)是医学领域中一个新兴的领域,它包含复杂的程序,不仅对能够使用这种方法的个人,而且对整个社会都具有深远的伦理、道德、社会、宗教和经济影响。在这篇叙述性综述中,我们总结了ART程序的多个方面以及对母亲和新生儿可能产生的后果。此外,我们概述了ART程序对新生儿健康可能产生的长期后果,尽管纵向证据特别稀少。应告知使用者,ART程序并非没有风险,以便让他们为围产期甚至儿童期和成年期可能出现的负面结果做好准备。事实上,风险评估表明,主要非染色体出生缺陷、心血管、肌肉骨骼和泌尿生殖系统(男性新生儿)缺陷以及任何其他出生缺陷的责任风险增加。通过ART受孕的儿童患神经精神后遗症的风险存在的不确定性较小。因此,其应用应伴有充分的咨询和心理支持,并可能纳入特定的多学科临床项目。

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Long-term outcomes for children conceived by assisted reproductive technology.辅助生殖技术受孕儿童的长期结局。
Fertil Steril. 2023 Sep;120(3 Pt 1):449-456. doi: 10.1016/j.fertnstert.2023.04.022. Epub 2023 Apr 20.

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