辅助受孕儿的出生情况及智力发育水平追踪研究

Study on the neonatal outcomes and the intelligence development of children with assisted conception

目的通过研究辅助受孕儿出生时的新生情况及持续追踪至8岁的智力发育水平,以评价辅助生殖技术的安全性。方法采用前瞻性对照研究方法,试验组为人工辅助受孕儿,对照组为自然受孕儿,均自母亲孕28周起入组登记定期随访收集相关资料至出生,生后由经过培训的指定专业人员将相关新生儿情况登记入案,并定期跟踪,0~3岁采用CDCC婴幼儿发育量表,每间隔6个月进行一次精神运动发育评估,3岁以上采用斯坦福-比奈智力量表,每间隔12个月进行一次智力测试。结果辅助受孕组新生儿中双胎儿、早产、低出生体重、新生儿期入住NICU等发生率明显高于自然受孕对照组,单独比较两组中的单胎儿时,差异无统计学意义。但辅助受孕组剖宫产发生率仍明显高于自然受孕组。另对不同辅助受孕方式产生的子代组间进行比较,差异无统计学意义(P>0.05)。持续追踪两组儿童至8岁,其智力发育水平差异亦无统计学意义(P>0.05)。结论辅助受孕子代的新生儿情况更差,主要归因于其高发的双胎及多胎妊娠率;辅助受孕儿童生长至学龄时智力发育水平正常;不同辅助受孕方式对其子代的出生情况及智力发育无影响。

Objective To compare the neonatal outcomes and the intelligence development at 8 years old in children born after assisted conception with a control group of children conceived naturally.Methods A prospective control study was performed. The experimental group were children born after assisted conception, the control group were children born after natural conception. The mothers were invited to participate at 28 weeks of gestation and were followed up to delivery.Related data were collected and registered by trained professionals.The children of two groups were followed up to 8 years old. A formal developmental assessment was conducted with the CDCC Scales of Children Development when they were under 3 years old and a formal intelligence assessment was done with the Stanford-Binet Intelligence Tests when they were over 3 years old. Results In the assisted conception group, the incidence rates of twins preterm birth, low birth weight and admission to Neonatal Intensive Care Unit（NICU） were significantly higher than those of the control group.But these differences seemed to disappear when only singletonswere compared between the two groups.And the differences were not significant on neonatal outcomes in infants conceived by different Methods of assisted conception （IVF-ET、ICSI、FET）. No statistically significant differences were found in the intelligence development at 8 years old between the experimental group and the control group. Conclusions Neonatal outcomes after assisted conception is worse than natural conception, mainly due to the large proportion of multifetal births after assisted conception. Followed up to 8 years old, the level of intelligence development in children born after assisted conception is normal.And the growth and development of the offsprings by using different ways of assisted conception are similiar.