辅助生殖技术试管足月儿神经心理行为发育的纵向研究

Longitudinal study on neuropsychological and behavioral development of test-tube full-term infants with assisted reproduction technology

目的比较辅助生殖技术(ART)试管足月儿的体格发育、神经心理行为发育水平与自然受孕(NC)婴儿的差异,为促进试管婴儿早期全面发展提供科学依据。方法采用1:1对照研究方法,于2019年1月1日—2020年12月31日期间纳入60例ART足月儿和60例NC足月儿收集相关信息,并随访6月龄和12月龄健康体检信息,采用儿-心量表(2016版)进行评估。结果ART足月儿父母生育年龄、妊娠合并症发生率、剖宫产率多胎率均高于NC足月儿,差异有统计学意义(t=11.141、15.392,χ^(2)=23.008、28.104、36.936,P<0.001),但两组足月儿出生身长、体重以及出生合并疾病发生率比较,差异均无统计学意义(P>0.05)。ART足月儿6月龄和12月龄体格发育水平和趋势与NC足月儿一致,差异均无统计学意义(P>0.05)。ART足月儿6月龄精细运动和语言能力、总发育商低于NC组,差异有统计学意义(t=6.455、4.583、6.895,P<0.05),两组儿童12月龄神经心理行为发育水平比较,差异均无统计学意义(P>0.05)。结论虽然ART足月儿胎儿期面临不良高危因素,但出生时和婴儿期体格发育均达到NC婴儿水平;婴儿早期精细运动和语言能力低于NC婴儿,但12月龄均赶上发育,提示婴儿早期全面发展促进工作的重要性。

Objective To compare the physical development and neuropsychological development level of test-tube fullterm infants by assisted reproductive technology(ART)with that of naturally conceived(NC)healthy infants,so as to provide a scientific basis for the early comprehensive development of test-tube infants.Methods Totally 60ART term infants and 60NC term infants were enrolled and their relevant information was collected in this study from January 1st,2019to December 31st,2020.Infants′health check-up data were followed up at 6and 12 months old.The Children′s Neuropsychological Behavioral Development Assessment(2016 version)was used to assess the neuropsychological behavioral development of infants.Results There were significant differences on parental age,the incidence of pregnancy complications and cesarean section and multiple fetus rate between ART infants and NC term infants(t=11.141,15.392,χ^(2)=23.008,28.104,36.936,P<0.001),but the differences in the length and weight at birth and incidence of birth complications between the two groups were not significant(P>0.05).ART term infants and NC term infants had the consistent trends on physical development levels at 6months old and 12months old(P>0.05).At 6months old,the scores of fine motor development,language development and total development quotient of ART infants were significantly lower than those of NC infants(t=6.455,4.583,6.895,P<0.05),but the neuropsychological and behavioral development levels of the two groups were similar at 12months old(P>0.05).Conclusions Although assisted reproduction full-term testtube infants face adverse high-risk factors during the fetal period,the physical development at birth and infancy reaches the level of naturally conceived infants.The early development of fine motor and language skills of ART infants is lower than that of naturally conceived infants,but they can catch up with the level of naturally conceived babies at the age of 12months old,indicating the importance of promoting the early comprehensive development of ART infants.