辅助生殖技术受孕儿童学龄前期体格及神经心理行为发育研究

Physical and neuropsychological behavioral development of preschool children conceived through assisted reproductive technology

摘要

目的 了解辅助生殖技术(ART)受孕儿童在学龄前期的体格及神经心理行为发育状况,为ART儿童健康管理提供科学依据。方法 选取2023年1月—2024年12月大连市妇女儿童医疗中心(集团)招募的3~6岁ART受孕儿童65例,按1∶1比例匹配同龄自然受孕(NC)儿童作为对照组。对比两组儿童的围生期情况、体格指标[身高、体重、体质量指数(BMI)、血压等],并采用0~6岁儿童神经心理行为量表(2016版)评估发育状况。结果 ART组父母生育年龄显著大于NC组(t=7.184、8.337,P<0.05)。ART组母亲孕期增重(t=3.237)、多胎妊娠率、早产率(χ²=9.531)、妊娠期合并症发生率(χ²=10.586)、剖宫产率(χ²=12.671)及新生儿住院率(χ²=13.510)均高于NC组(P<0.05);但在调整多胎妊娠因素后,除父母生育年龄外,两组上述围生期指标差异无统计学意义(P>0.05)。体格发育方面,两组身高、体重及血压无显著差异,但ART组BMI、腰围及超重/肥胖检出率高于NC组,差异有统计学意义(t=2.067、3.781,Z=-2.194,P<0.05)。神经心理方面,两组在大运动、精细运动、适应能力、警示行为及总发育商评分上差异无统计学意义(P>0.05);ART组语言能力及社会行为评分显著高于NC组(t=3.764、2.210,P<0.05)。性别亚组分析显示,ART组男童语言评分显著优于NC组男童(t=3.565,P=0.001),两组女童各项能区评分无显著差异。结论 矫正多胎因素后,ART儿童围生期不良结局风险未见明显增加。学龄前期ART儿童体格及神经心理发育总体良好,其语言及社会行为表现优于自然受孕儿童,尤其是男童语言优势明显;但ART儿童面临更高的超重/肥胖风险,需加强对其营养状况及BMI的长期监测与干预。

Abstract

Objective To investigate the physical growth and neuropsychological behavioral development of preschool children conceived through assisted reproductive technology (ART), so as to provide scientific evidence for their health management. Methods A total of 65 ART-conceived children aged 3 to 6 years were recruited from Dalian Women and Children′s Medical Group between January 2023 and December 2024.A control group of 65 naturally conceived (NC) children, matched 1:1 for age, was selected.Physical development indicators were assessed, including height, weight, body mass index (BMI), blood pressure, etc., and the Children Neuropsychological and Behavioral Scale (2016 Edition) was used to evaluate developmental status. Results The parental age in the ART group was significantly higher than that in the NC group (t=7.184, 8.337, P<0.05).Although maternal weight gain during pregnancy (t＝3.237), as well as the rates of multiple pregnancy, preterm birth (χ²=9.531), pregnancy complications (χ²=10.586), cesarean section (χ²=12.671), and neonatal hospitalization rate(χ²=13.510) were higher in the ART group (P<0.05), no statistically significant differences were found in these perinatal outcomes after adjusting for multiple pregnancies (P>0.05).Regarding physical development, there were no significant differences in height, weight, or blood pressure between the two groups; however, the BMI, waist circumference, and prevalence of overweight/obesity were significantly higher in the ART group compared to the NC group (t=2.067,3.781,Z=-2.194,P<0.05).In terms of neuropsychological development, no significant differences were observed in gross motor, fine motor, adaptive ability, warning behavior, or total developmental quotient (P>0.05).However, the ART group scored significantly higher in language ability and social behavior than the NC group (t=3.764,2.210,P<0.05).Subgroup analysis by gender revealed that boys in the ART group had significantly better language scores than boys in the NC group (t=3.565, P=0.001), while no significant differences were found between girls in the two groups across all developmental domains. Conclusions After adjusting for multiple pregnancies, the risk of adverse perinatal outcomes in ART children does not increase significantly.In the preschool period, ART children demonstrate generally good physical and neuropsychological development, with better performance in language and social behavior compared to NC children, particularly in language skills among boys.However, ART children are at a higher risk of overweight and obesity, suggesting a need for regular monitoring and intervention regarding their nutritional status and BMI.

关键词

辅助生殖技术 / 学龄前儿童 / 围生期 / 体格发育 / 神经心理发育

Key words

assisted reproductive technology / preschool children / perinatal period / physical development / neuropsychological development

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基金资助

大连市妇女儿童医疗中心(集团)博士启动基金项目(2022年)