目的 运用倾向性评分匹配(PSM)法探讨辅助生殖技术(ART)对子代全身运动评估(GMs)结果的影响,为ART的远期效果提供参考依据。方法 2015年7月—2017年10月收集在闵行区至少有一次GMs评估且采集信息完整者为研究对象。运用PSM对GMs “早产/扭动”和 “不安运动”两阶段首次结果分别设置匹配容差为0.000 03和0.000 15进行1∶1匹配,分组为ART受孕组和自然受孕组,匹配变量为“性别、出生体重、孕周、胎数,出生抢救史、黄疸、神经疾病和其它疾病史,父母亲的年龄、文化、职业,母亲孕期保胎、服药、糖尿病、高血压和其它疾病史”,比较匹配前后组间差异。结果 匹配前,在GMs两阶段ART受孕组结果异常率高于自然受孕组,差异均有统计学意义(χ²＝77.74和15.38,P＜0.01);匹配后,“早产/扭动”阶段配对数为164,ART受孕组结果异常率(32.3%)显著高于自然受孕组(18.9%)(χ²=8.30,P=0.008);“不安运动”阶段配对数为247,组间差异无统计学意义(P>0.05)。结论 ART可能增加了子代“早产/扭动”阶段结果异常的风险,其远期意义有待进一步研究。

Objective To explore the impact of the assisted reproductive technology (ART) on the offsprings′ general movement assessment (GMs) by applying propensity score matching . Method Infants who had received at least one time of GMs were collected in Minhang district from July 2015 to October 2017.Infants were divided into two groups of ART conceived and natural conceived.The first time of GMs results of the two groups during the two stages of “premature and twist” and “restless movement ” were matched by applying the one-to-one propensity score matching (PSM),setting the matching tolerance 0.000 03 and 0.000 15 respectively,with the gender,fetus number,birth weight,gestational age,the history of rescue,jaundice,brain and other disease,parental age,culture,occupation,maternal fetal miscarriage,medication,diabetes,or hypertension the history of other diseases as covariates.The differences between the two groups were compared. Results Before matched, the rate of abnormal result of two GMs stages in ART conceived group was significantly higher than that in natural conceived group(χ²=77.74,15.38,both P＜0.01).After matched,there were 164 pairs of data in the stage of premature and twist,and the rate of abnormal result of ART conceived group was significantly higher than that of natural conceived group (32.3% vs.18.9%,χ²=8.30,P=0.008).However,there was no significant difference between the two groups of 247 pairs of data in the stage of restless exercise (P>0.05). Conclusions ART may increase the risk of abnormal result in the stage of “premature and twist”,so further research is needed.