Saunders K, Spensley J, Munro J, Halasz G
Monash University Department of Psychological Medicine, Monash Medical Centre, Victoria, Australia.
Pediatrics. 1996 May;97(5):688-92.
To determine the growth and physical outcome at 2 years of age for children born after assisted reproductive techniques in the state of Victoria.
Using a case-matched control study between January 1991 and July 1993, 314 children (196 singletons, 47 sets of twins, 8 sets of triplets) conceived after in vitro fertilization (IVF) and related techniques at the Monash IVF and Royal Women's Hospital Reproductive Biology Unit and 150 control children (113 singletons, 17 sets of twins, 1 set of triplets) randomly selected from the general population using the Victorian Perinatal Data Collection Unit records were enrolled to be examined for minor dysmorphic and major organ abnormalities. Singleton and twin cases were matched for plurality and gestation and date of birth. Triplets were not matched.
IVF status was not a significant independent factor for physical outcomes, including malformation rates, nor for days of hospitalization postdischarge and operations. There was no significant interaction between IVF status and mean percentiles for weight and head circumference. The IVF group had a greater mean length percentile. Twins in both groups had significantly poorer physical outcomes than singletons on some measures.
This study did not demonstrate an independent IVF effect on the growth and physical outcome of children at 2 years of age when matched for plurality and gestation. The poor outcomes where noted were related to the effects of multiple births. These findings must be viewed in context of the response rates and therefore representativeness of the data. The need for longitudinal studies is demonstrated.
确定维多利亚州通过辅助生殖技术出生的儿童在2岁时的生长发育及身体状况。
采用病例对照研究，在1991年1月至1993年7月期间，选取在莫纳什体外受精中心和皇家妇女医院生殖生物学单位通过体外受精（IVF）及相关技术受孕的314名儿童（196名单胎、47对双胞胎、8对三胞胎），以及从维多利亚围产期数据收集单位记录中随机选取的150名对照儿童（113名单胎、17对双胞胎、1对三胞胎），对他们进行轻微畸形和主要器官异常检查。单胎和双胞胎病例按胎数、孕周和出生日期进行匹配。三胞胎不进行匹配。
体外受精状况对于包括畸形率在内的身体状况，以及出院后住院天数和手术情况而言，并非显著的独立影响因素。体外受精状况与体重和头围的平均百分位数之间不存在显著交互作用。体外受精组的平均身长百分位数更高。在某些指标上，两组中的双胞胎身体状况均明显比单胎差。
本研究表明，在按胎数和孕周匹配后，体外受精对2岁儿童的生长发育及身体状况并无独立影响。所观察到的不良状况与多胎妊娠的影响有关。这些发现必须结合应答率以及数据的代表性来考量。这表明有必要开展纵向研究。
