在辅助生殖技术后怀孕的儿童的神经发育或行为障碍:全国性的队列研究
Patricia Angel1, Maja Hermansen1, Cecilia Høst Ramlau-Hansen2
1Department of Epidemiology, Institute of Public Health, University of Southern Denmark, Odense, Denmark; Interdisciplinary Center on Population Dynamics (CPop), University of Southern Denmark, Odense C, Denmark.
Fertility and sterility
|October 19, 2024
概括
通过辅助生殖技术 (ART) 怀孕的儿童显示神经发育或行为障碍的药物治疗几率略有增加. 然而,研究发现很少有明显增加风险的证据,考虑到诸如出生体重和父母的注意力等因素.
科学领域:
- 生殖医学 生殖医学
- 儿科神经学 儿科神经学
- 公共卫生 公共卫生
背景情况:
- 辅助生殖技术 (ART) 在全球范围内越来越多地使用.
- 人们对通过ART怀孕的儿童潜在的长期神经发育或行为结果存在担忧.
- 了解这些风险对于家长咨询和临床实践至关重要.
研究的目的:
- 为了调查通过ART怀孕的儿童与自然怀孕的儿童相比,药物治疗的神经发育或行为障碍的风险.
- 为了确定不同的ART方法是否会影响这些风险.
主要方法:
- 丹麦 (1994-2012) 全国基于登记的队列研究.
- 包括0-7岁的活生生的孩子,比较那些通过ART (体外受精,细胞内精子注射,子宫内授精等) 怀孕的孩子. 与自然受孕的孩子们.
- 对神经发育/行为障碍 (抗精神病药物,多动症药物等) 的药物处方. 通过调整的赔率比率和灵敏度分析进行了分析.
主要成果:
- 该研究包括超过120万名儿童,其中4.7%通过ART怀孕.
- 接受ART治疗的儿童接受神经发育或行为障碍的药物治疗的几率略高 (调整后OR: 1.15;95%CI: 1.09-1.20).
- 出生体重部分调解了这一关联,兄弟姐妹分析显示家庭内风险没有增加.
结论:
- 观察到的效应是轻微的,出生体重和早产调解了这种关联.
- 父母对ART孕育的孩子的注意力增加也可能起到作用.
- 总的来说,有限的证据表明,在ART孕育的儿童中,神经发育或行为障碍的风险显著增加.
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