试管婴儿在婴幼儿期体格和精神运动发育状况分析

Growth and psychomotor development of children conceived by IVF or ICSI

目的初步评价试管婴儿的体格和精神运动发育情况。方法选取通过试管婴儿出生的婴幼儿101例(单胎儿65例,双胎儿36例),随机抽取同期自然受孕出生的单胎婴幼儿79例,双胎婴幼儿22例作为对照,对比其出生情况、体格和精神运动发育情况。结果试管婴儿单胎,其出生身长、母亲生产年龄、BMI大于自然出生单胎(P<0.05),而MDI、PDI和家庭情况各项指标的差异无统计学意义(P>0.05);试管婴儿与自然受孕出生双胎情况的各项指标差异均无统计学意义(P>0.05)。试管婴儿双胎的出生体重和随访时的BMI比单胎低(P<0.05),但MDI、PDI及精神运动发育迟缓的百分率差异无统计学意义(P>0.05)。多因素分析发现,母亲的职业对MDI的影响有统计学意义(P<0.05),父亲的文化程度对PDI的影响有统计学意义(P<0.05),胎数对低出生体重和早产的影响有统计学意义(P<0.05)。结论婴幼儿的身体发育和营养情况与低出生体重有关,并受母亲文化程度的影响。自然妊娠与试管婴儿出生儿童的精神运动发育指标没有明显差别。

Objective To investigate the physical and mental development of IVF/ICSI children. Methods The neonatal outcome, the physical and mental development of the children conceived by IVF/ICSI or nature was evaluated. Results Compared to NC singletons, IVF/ICSI singletons have longer birth body length, higher BMI and elder mother＇s age. There was no significant difference in the psychomotor development and family background between the two groups. No significant difference was found between the IVF/ICSI twins and NC twins. Among IVF/ICSI children, the twins had significant lower birth weight and BMI than singletons. A multivariate regression analysis for all the children indicated that mother＇ s occupation had a significant influence on MDI of children. According to PDI of children, father＇ s education level had a significant influence on it. On the other hand, low birth weight remained as a factor that influences BMI. However, the procedure of IVF or ICSI did not influence the result of MDI, PDI or BMI of children. Twins pregnancy stayed in the regression as a factor accounting for low birth weight and premature birth. Conclusion Although the physical development of children is associated with low birth weight, mother＇s education level has an influence on it. No significantly difference was found in the psychomotor development between NC and IVF/ICSI children.