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The cognitive and socio-emotional development of 5-year-old children born after PGD
M Heijligers1,2, L M M Verheijden1,3, L M Jonkman4
1Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands.
Insights
Children born after preimplantation genetic diagnosis (PGD) show normal cognitive and socio-emotional development at age five. This study found no significant differences compared to children conceived via IVF/ICSI or naturally conceived children.
Area of Science:
- Reproductive medicine
- Developmental psychology
- Genetics
Background:
- Limited studies suggest comparable development in children born after PGD/PGS versus IVF/ICSI or natural conception.
- Previous research often involves small sample sizes.
Purpose of the Study:
- To investigate the cognitive and socio-emotional development of 5-year-old children born after PGD.
- To compare PGD children with IVF/ICSI and naturally conceived (NC) children from families with genetic disorders.
Main Methods:
- Neuropsychological testing (WPPSI-III-NL, AWMA) was conducted on 5-year-old children.
- Parent and teacher questionnaires (BRIEF, CBCL, C-TRF) assessed executive functioning and socio-emotional development.
- Study included 51 PGD, 52 IVF/ICSI, and 35 NC children.
Main Results:
- Cognitive development (IQ, AWMA tasks) was comparable across all three groups.
- Teachers reported more externalizing and total problem behaviors in PGD children than IVF/ICSI children, but all scores were within the normal range.
- A higher proportion of PGD children had family members with genetic disorders.
Conclusions:
- Children born after PGD demonstrate normal cognitive and socio-emotional development at age five.
- Findings hold despite the PGD biopsy procedure and potential family psychological burden.
- Results support the safety of PGD concerning child development.
Study Question:
Does PGD increase the risk on adverse cognitive and socio-emotional development?
Summary Answer:
The cognitive and socio-emotional development in children born after PGD seems to be normal when compared to control groups.
What Is Known Already:
A limited number of studies with small sample sizes indicate that the cognitive and socio-emotional development of (pre)school-aged children born after either PGD or PGS seem to be comparable to those of children born after IVF/ICSI and to naturally conceived (NC) children from the general population.
Study Design, Size, Duration:
For this study we invited 72 5-year-old PGD children, 128 5-year-old IVF/ICSI children and 108 5-year-old NC children from families with a genetic disorder. All children were invited between January 2014 and July 2016.
Participants/Materials, Setting, Methods:
In total, 51 PGD children, 52 IVF/ICSI children and 35 NC children underwent neuropsychological testing (WPPSI-III-NL and AWMA). The children's parent(s) and teachers filled in questionnaires evaluating children's executive functioning (Behaviour Rating Inventory of Executive Functions; BRIEF) and socio-emotional development (Child Behaviour Checklist; CBCL and Caregiver-Teacher Report Form; C-TRF).
Main Results And The Role Of Chance:
The mean full-scale intelligence quotient scores (P = 0.426) and performance on the AWMA Listening Span task (P = 0.873) and Spatial Span task (P = 0.458) were comparable between the three groups. Regarding socio-emotional development, the teachers' scores revealed more externalizing (P = 0.011) and total problem (P = 0.019) behaviour in PGD children than for IVF/ICSI children; both groups did not differ significantly from the NC children (P = 0.11). More children (13%) with an affected first-degree family member (mostly parent) were included in the PGD group than in the NC group. Scores in all groups fell within the normal population range and should be considered normal.
Limitations, Reasons For Caution:
The number of NC children from families with a genetic disorder was relatively small. Furthermore, the fathers' CBCL results were based on small samples.
Wider Implications Of The Findings:
PGD children show levels of cognitive and socio-emotional development at 5 years that are within the normal range, despite the biopsy involved in PGD and the potential extra psychological burden associated with the presence of a genetic disorder in the family.
Study Funding/Competing Interest(S):
This study was funded by ZonMw (70-71300-98-106). None of the authors have any competing interests to declare.
Trial Registration Number:
NCT02149485.
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