目的 分析辅助生殖技术(ART)受孕与自然受孕双胎早产儿的出生结局差异,并评估其早期神经行为发育特征,为ART受孕婴儿的健康管理提供合理建议。 方法 采用回顾性队列研究方法选取2017年1月—2022年1月在西安市儿童医院儿童保健科门诊定期体检的双胎早产儿,共147对(n=294例)。根据不同受孕方式分为两组:ART受孕双胎早产儿78对为观察组(n=156例)和自然受孕双胎早产儿69对为对照组(n=138例)。收集两组孕产妇妊娠期疾病、双胎早产儿生后临床疾病等资料,两组早产儿均在矫正胎龄生后6月龄和12月龄时行Gesell发育行为评估。 结果 两组孕产妇妊娠期疾病发生率差异无统计学意义(P＞0.05)。观察组早产儿先天性心脏病发生率高于对照组,差异有统计学意义(χ2=12.05, P＜0.01)。两组婴儿矫正胎龄生后6月龄、12月龄时行Gesell发育行为评估结果差异均无统计学意义(P＞0.05)。 结论 ART受孕的双胎早产儿患常见先天性心脏病风险更高,未发现复杂危重型先天性心脏病。两组双胎早产儿早期神经行为发育无显著差异,ART并未增加早产儿神经发育异常的风险。
Abstract
Objective To compare birth outcomes and early neurobehavioral development between preterm twins conceived via assisted reproductive technology (ART) and those conceived naturally, in order to provide evidence-based recommendations for the health management of in vitro fertilization (IVF) infants. Methods This retrospective cohort study included 147 twin pairs (n=294) of preterm infants who underwent regular health examinations at the Child Health Clinic of Xi′an Children′s Hospital between January 2017 and January 2022.Participants were divided into two groups: 78 ART-conceived twin pairs (observation group, n=156) and 69 naturally conceived twin pairs (control group, n=138).Data on maternal gestational complications and neonatal clinical conditions were collected.Neurodevelopmental outcomes were assessed using the Gesell Developmental Schedules (GDS) at corrected ages of 6 and 12 months. Results No significant differences were observed in the incidence of maternal gestational complications between the two groups (P>0.05).The observation group exhibited a higher prevalence of congenital heart disease (CHD) compared to the control group (χ2=12.05, P < 0.05).However, no significant differences were found in GDS scores at 6 or 12 months of corrected age (P>0.05). Conclusions ART-conceived preterm twins have an increased risk of common CHD, but no cases of severe or complex CHD are identified.Early neurobehavioral development do not differ significantly between ART and naturally conceived preterm twins, suggesting that ART does not elevate the risk of neurodevelopmental abnormalities in this population.
关键词
辅助生殖技术 /
双胎早产儿 /
出生结局 /
神经行为发育
Key words
assisted reproductive technology /
twin premature infants /
birth outcome /
neurobehavioral development
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基金
国家自然科学基金(81371900);陕西省重点研发计划(2020GXLH-Y-013,2021SF-194);陕西省科学技术研究发展计划(213ST2-09);陕西省自然科学基础研究计划(2022JQ-979);西安市科技计划项目[20YXYJ0006(4)];陕西中医药大学中西医结合防治脑发育障碍性疾病创新团队(2019-YL07);上海申康医院发展中心临床三年行动计划资助(SHDC2020CR1047B)
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