目的 评价辅助生殖技术(ART)出生子代远期体格和精神发育状况,探讨ART的安全性。方法 选取2010年1月—2015年6月在江苏省人民医院生殖中心通过ART助孕出生的、年龄6个月～6岁的210例儿童为ART组,同期在本院产科自然分娩的年龄、性别、家庭经济状况相似的139例儿童为对照组(NC组)。对每位儿童进行精神运动发育评估,＜4岁采用盖塞尔婴幼儿发育量表(GESELL),≥4岁采用韦氏学前儿童智力量表(C-WPPSI)。结果 本试验共纳入研究对象349例,采用GESELL测试225例,C-WPPSI测试124例。ART组父母生育年龄(岁)(父 33.21±4.46 vs.31.16±3.52,t=2.99;母 31.65±5.21 vs.29.55±4.07,t=3.93)、双胎比例(20.0% vs.7.3%,χ2=7.24)及剖宫产比例(80.4% vs.57.6%,χ2=11.31)显著高于NC组(P<0.01)。ART和NC组儿童身高、体重及体重指数(BMI)的Z评分比较,差异无统计学意义(P＞0.05)。经GESELL与C-WPPSI评估,两组儿童的大运动、精细动作、适应能力、语言、社交能力5大能区得分及总智商、言语商、操作商比较,差异均无统计学意义(P＞0.05)。结论 随访至6岁,辅助生殖技术出生儿童与自然受孕出生儿童体格和精神运动发育无显著差异,提示ART操作对其子代的精神、运动发育无明确影响。
Abstract
Objective To study the long-term status of physical and psychomotor development in children born after assisted reproductive technology(ART),in order to evaluate the safety of ART.Methods Totally 210 children aged 6 months to 6 years,who were born after ART in Reproductive Center of Jiangsu People′s Hospital from January 2010 to June 2015,were enrolled as ART group,and 139 children matched with general characteristics were selected as control group.The psychomotor development of participants were assessed with Chinese Wechsler Preschool and Primary Scale of Intelligence(C-WPPSI) (for children under 4 years old) and Gesell Developmental Diagnosis Scale (GESELL) ( for children over 4 years old). Results Totally 349 children participated in this study,of which 225 were assessed with GESELL test and 124 were tested with C-WPPSI.In addition to the parents′ age (father 33.21±4.46 vs.31.16±3.52,t=2.99;mother 31.65±5.21 vs.29.55±4.07,t=3.93),the proportion of twins (20.0% vs.7.3%,χ2=7.24) and the cesarean section rate (80.4% vs.57.6%,χ2=11.31) of ART group were significantly higher than those of normal control group (P＜0.01).However,there were no significant differences on Z scores of height,weight and body mass index (BMI) between ART group and normal control group (P＞0.05).The long-term physical and psychomotor development of the offspring by ART group were not statistically significant compared with that in NC group (P＞0.05). Conclusion The offspring born after ART and normal delivery have no significant differences on physical and psychomotor development when followed up to 6 years old,indicating ART is relatively safe on physical and psychomotor development.
关键词
辅助生殖技术 /
体格发育 /
精神发育 /
儿童
Key words
assisted reproductive technology /
physical development /
psychomotor development /
children
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参考文献
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基金
国家重点基础研究计划(2012CB944902);重点研发计划(2016YFC1000200,2017YFC1001300);国家自然科学基金(81401265);江苏省科技厅项目(BK20141025)
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