Chen Anni, Wang Dongyang, Zhang Yuyu, Dai Qianqian, Yang Weixia, Zhou Zixiao, Shi Xuan, Zhou Ziyue, Ni Zijun, Zhuang Xun
Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, China.
Medical Department, The Affiliated Maternity and Child Health Hospital of Nantong University, Nantong, Jiangsu, China.
Acta Obstet Gynecol Scand. 2025 Sep;104(9):1672-1682. doi: 10.1111/aogs.15178. Epub 2025 Jun 30.
Globally, the number of assisted reproductive technology (ART) infants has surpassed 10 million, with its utilization steadily increasing. Numerous studies have shown that ART pregnancies are more prone to adverse pregnancy outcomes. ART infants are at a higher risk for adverse birth outcomes. However, the differences in growth between ART and natural pregnancy (NP) infants remain controversial. This study aims to explore differences in pregnancy outcomes, birth outcomes, and growth rates between ART and NP infants during the first year of life, and to analyze the association between ART and rapid growth.
Birth records of the Nantong area, China, from January 2020 to June 2021 were extracted. A total of 29 886 pregnant women and 30 051 infants were included in the characteristic analysis. Based on the use of ART recorded in the database, the pregnant women and infants were categorized into ART and NP groups, with the NP serving as the control group. For the growth analysis, 29 447 singleton infants were included. Growth within 12 months was examined using the LMS method. The association between reproductive methods, perinatal sociodemographic characteristics, infant birth characteristics, and rapid growth was analyzed using GEE model. To further explore the association between ART and rapid growth, we performed subgroup analyses based on infants' sex, birth weight, and perinatal residence, which were statistically associated with rapid growth in the multivariate GEE model.
ART infants had higher rates of preterm birth (7.4% vs. 4.8%) and cesarean section (57.7% vs. 49.1%; p < 0.001 for both). Growth analysis displayed faster overall growth rates and higher rapid growth incidence in ART singleton infants. Multivariate GEE analysis showed that ART was associated with a higher incidence of rapid growth in both length (OR = 1.415, 95% CI: 1.316-1.521) and weight (OR = 1.236, 95% CI: 1.134-1.348).
ART singleton infants demonstrated a greater likelihood of experiencing rapid growth, despite being at higher risk of SGA, and achieved growth trajectories comparable to NP singleton infants. The findings suggest that ART may not influence postnatal growth. These results underscore the importance of tailored clinical monitoring and interventions for ART infants to ensure optimal growth and long-term health.
在全球范围内，辅助生殖技术（ART）出生的婴儿数量已超过1000万，并且其应用仍在稳步增加。大量研究表明，ART妊娠更容易出现不良妊娠结局。ART出生的婴儿出现不良出生结局的风险更高。然而，ART婴儿与自然妊娠（NP）婴儿在生长方面的差异仍存在争议。本研究旨在探讨ART婴儿与NP婴儿在出生后第一年的妊娠结局、出生结局和生长速度的差异，并分析ART与快速生长之间的关联。
提取了中国南通地区2020年1月至2021年6月的出生记录。共有29886名孕妇和30051名婴儿纳入特征分析。根据数据库中记录的ART使用情况，将孕妇和婴儿分为ART组和NP组，以NP组作为对照组。对于生长分析，纳入了29447名单胎婴儿。使用LMS方法检查12个月内的生长情况。使用广义估计方程（GEE）模型分析生殖方式、围产期社会人口学特征、婴儿出生特征与快速生长之间的关联。为了进一步探讨ART与快速生长之间的关联，我们根据婴儿性别、出生体重和围产期居住地进行了亚组分析，这些因素在多变量GEE模型中与快速生长具有统计学关联。
ART婴儿的早产率（7.4%对4.8%）和剖宫产率（57.7%对49.1%；两者p均<0.001）更高。生长分析显示，ART单胎婴儿的总体生长速度更快，快速生长发生率更高。多变量GEE分析表明，ART与身长（比值比[OR]=1.415，95%置信区间[CI]：1.316-1.521）和体重（OR=1.236，95%CI：1.134-1.348）快速生长的发生率更高相关。
尽管ART单胎婴儿发生小于胎龄儿（SGA）的风险较高，但出现快速生长的可能性更大，并且其生长轨迹与NP单胎婴儿相当。研究结果表明，ART可能不会影响出生后的生长。这些结果强调了对ART婴儿进行针对性临床监测和干预以确保最佳生长和长期健康的重要性。
