[In vitro fertilization neonates transferred to neonatal medicine. Mid-and long-term outcome in 99 families].

OBJECTIVE

To assess the physical and neurodevelopmental status of children born after in vitro fertilization (IVF) as well as the family condition.

DESIGN

Follow-up study including physical and developmental examination in available families, and/or interviews of parents/pediatricians/teachers/social workers.

SETTING

The Port-Royal neonatal intensive care unit and follow-up clinic.

SUBJECTS

From 1.1.1987 to 31.12.1992, in 32 single, 71 twin, 28 triple, and one quadruple pregnancies resulting from IVF (total 132), one or more neonates were admitted to the Port-Royal NICU. The outcome is presented for the 99 families followed longer than two years (199 neonates, 166/199 born prematurely).

MAIN OUTCOME MEASURES

Neurological sequelae (minor, moderate, major), developmental quotients, school level, behavioral disturbances, family conditions.

RESULTS

From 21 singletons (2 deaths, 1 lost), 18 survivors were followed: 17 were normal above 2 years (10 above 3 years went to school), 1 had a severe cerebral palsy with low IQ. From 57 twin pregnancies (7 fetal and 9 neonatal deaths), the 98 survivors were followed: 78 were normal above 2 years (65 above 3 years went to school), 20 had some neuro-developmental deficits (of 14 above 3 years, 12 went to school); 25 families had had or still had problems (deaths and/or anomalies (9 cases) and/or sequelae); 3 mothers were single parents (2 divorces and one split). From 20 triple pregnancies (1 fetal and 3 neonatal deaths), 54 out of 56 survivors were normal above 2 years (33 above 3 years went to school); 3 siblings (1 deaf and 1 with cataract) were put in foster care after severe maternal beating; 2 mothers were single parents (one divorce and one split); 4 mothers had repeated breakdowns; one father tried suicide. From one quadruple pregnancy (one fetal and one neonatal deaths), the 2 survivors were normal above 3 years and went to school. Most sequelae involved very low birthweight babies, in association with a number of sleep and behavioural disturbances. From 98 mothers, 16 had 18 spontaneous pregnancies (11 full-term newborns, 5 miscarriages, 1 extra-uterine pregnancy, 1 abortion) and 3 mothers had another IVF pregnancy (a few others had IVF failures).