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Published on: February 28, 2014
[In vitro fertilization neonates transferred to neonatal medicine. Mid-and long-term outcome in 99 families]
M Monset-Couchard1, O de Bethmann, J P Relier
1Unité de Soins Intensifs Néonatals de Port-Royal, CHU Cochin-Port-Royal, Paris.
Insights
Children born via in vitro fertilization (IVF) generally show good physical and neurodevelopmental outcomes. However, some may experience deficits, particularly those born prematurely, highlighting the need for continued monitoring and support for IVF families.
Area of Science:
- Reproductive Medicine
- Pediatrics
- Developmental Psychology
Background:
- In vitro fertilization (IVF) has become a common assisted reproductive technology.
- Assessing the long-term health and developmental outcomes of children conceived via IVF is crucial.
- Understanding the impact on family well-being is also important.
Purpose of the Study:
- To evaluate the physical and neurodevelopmental status of children born following IVF.
- To assess the overall condition and challenges faced by families with IVF-conceived children.
Main Methods:
- A follow-up study was conducted involving physical and developmental examinations.
- Interviews were held with parents, pediatricians, teachers, and social workers.
- Data were collected from families with neonates admitted to the Port-Royal NICU between 1987 and 1992.
Main Results:
- Most singleton and multiple IVF-conceived children followed for over two years exhibited normal development.
- A significant proportion of premature neonates, especially those with very low birth weight, experienced neurodevelopmental deficits and behavioral issues.
- Several families reported significant psychosocial challenges, including parental mental health issues and single-parent status.
Conclusions:
- While IVF can lead to successful pregnancies and generally healthy children, prematurity remains a risk factor for developmental issues.
- Comprehensive follow-up care is essential for IVF-conceived children, particularly those born preterm.
- Support services for families are vital to address the psychosocial and developmental needs of these children.
Objective:
To assess the physical and neurodevelopmental status of children born after in vitro fertilization (IVF) as well as the family condition.
Design:
Follow-up study including physical and developmental examination in available families, and/or interviews of parents/pediatricians/teachers/social workers.
Setting:
The Port-Royal neonatal intensive care unit and follow-up clinic.
Subjects:
From 1.1.1987 to 31.12.1992, in 32 single, 71 twin, 28 triple, and one quadruple pregnancies resulting from IVF (total 132), one or more neonates were admitted to the Port-Royal NICU. The outcome is presented for the 99 families followed longer than two years (199 neonates, 166/199 born prematurely).
Main Outcome Measures:
Neurological sequelae (minor, moderate, major), developmental quotients, school level, behavioral disturbances, family conditions.
Results:
From 21 singletons (2 deaths, 1 lost), 18 survivors were followed: 17 were normal above 2 years (10 above 3 years went to school), 1 had a severe cerebral palsy with low IQ. From 57 twin pregnancies (7 fetal and 9 neonatal deaths), the 98 survivors were followed: 78 were normal above 2 years (65 above 3 years went to school), 20 had some neuro-developmental deficits (of 14 above 3 years, 12 went to school); 25 families had had or still had problems (deaths and/or anomalies (9 cases) and/or sequelae); 3 mothers were single parents (2 divorces and one split). From 20 triple pregnancies (1 fetal and 3 neonatal deaths), 54 out of 56 survivors were normal above 2 years (33 above 3 years went to school); 3 siblings (1 deaf and 1 with cataract) were put in foster care after severe maternal beating; 2 mothers were single parents (one divorce and one split); 4 mothers had repeated breakdowns; one father tried suicide. From one quadruple pregnancy (one fetal and one neonatal deaths), the 2 survivors were normal above 3 years and went to school. Most sequelae involved very low birthweight babies, in association with a number of sleep and behavioural disturbances. From 98 mothers, 16 had 18 spontaneous pregnancies (11 full-term newborns, 5 miscarriages, 1 extra-uterine pregnancy, 1 abortion) and 3 mothers had another IVF pregnancy (a few others had IVF failures).

