辅助生殖技术对婴儿期体格及神经发育的影响

The effect of assisted reproductive technology on infant physical and neurodevelopment

目的:探讨辅助生殖技术(ART)对足月子代婴儿期体格及神经发育的影响,促进早期干预性措施的制定。方法:招募2020年1月至2021年1月在本院经行ART后获得妊娠分娩的足月子代(ART组),分成ART单胎组(n=166)和ART双胎组(n=26);并招募同期在本院分娩的自然妊娠的足月子代(NC组),分成NC单胎组(n=166)和NC双胎组(n=10),比较ART组和NC组子代出生时体格和神经发育状况,随访子代至12月龄,评估体格和神经发育状况。采用logistic回归分析ART相关影响因素,采用独立样本t检验、χ^(2)检验对纳入研究子代的基本情况,婴儿期体格和神经发育指标进行统计分析。结果:ART组父母生育年龄、剖宫产率均高于NC组(P<0.05),父母亲生育年龄大是ART组的显著影响因素;ART单胎组和ART双胎组,分别与NC单胎组和NC双胎组进行比较,出生至12月龄时的体重、身长和头围差异均无统计学意义(P>0.05);ART组和NC组子代出生后新生儿神经行为测定(NBNA)评分比较,差异无统计学意义(P>0.05);随访至12月龄时,进行0~6岁儿童心理神经发育量表(2016版)测评,总发育商及各个能区无显著差异(P>0.05)。结论:ART足月子代和NC足月子代在婴儿期体格发育和神经发育方面均无显著差异;ART双胎妊娠的足月子代中,发育不良风险未见升高。

Objective:To explore the effect of assisted reproductive technology(ART)on the physical and neurological development of full-term offspring during infancy,and to promote the formulation of early intervention measures.Methods:The full-term offspring who received delivery after undergoing ART in Wuhan First Hospital from January 2020 to January 2021 were recruited(ART group)and divided into ART singleton group(n=166)and ART twin group(n=26).The full-term offspring from naturally conceived(NC)pregnancies delivered in Wuhan First Hospital during the same period were recruited(NC group)and divided into NC singleton group(n=166)and NC twin group(n=10).The physical and neurodevelopmental status of the offspring in the ART group and the NC group at birth was compared,and the physical and neurodevelopmental status of the offspring at 12 months of age was followed up.Logistic regression was used to analyze the related influencing factors of ART,and independent sample t-test and Chi-squared test were used to statistically analyze the basic situation,infant physical growth and neurodevelopmental indicators of the included study offspring.Results:The childbearing age and cesarean section rate of parents in the ART group were higher than those in the NC group(P<0.05),and the older childbearing age of parents was a significant influencing factor in the ART group;the singleton group and twin group were compared with the NC singleton group and NC twin group,respectively.There were no statistically significant differences in weight,body length,and head circumference from birth to 12 months of age (P>0.05);there were no statistically significant differences in Neonatal Behavioral NeurologicalAssessment (NBNA) scores between the ART group and the NC group offspring (P>0.05);at the age of 12months of follow-up, there were no significant differences in total developmental quotient and various functionalareas (P>0.05) when evaluated with the Pediatric Heart Scale (2016 version). Conclusion: There are no significantdifferences in physical and neurodevelopment between ART and NC full-term offspring in infancy. There isno increased risk of stunting in the full-term offspring of ART twins.