运用倾向性评分匹配法探讨辅助生殖技术对子代1岁内PDMS评估结果的影响  

Study of the impact of the assisted reproductive technology on the offspring infant′s results of Peabody Developmental Motor Scale Ⅱ test by applying propensity score matching

作　　者：姜春花 肖丽萍 黄俊 李云 张莺 钟平莉 杨红[2] 苏怡[2] 骆丹丹[2] JIANG Chun-hua;XIAO Li-ping;HUANG Jun;LI Yun;ZHANG Ying;ZHONG Ping-li;YANG Hong;SU Yi;LUO Dan-dan(Shanghai Minhang Maternal and Child Health Care Hospital,Shanghai 201102,China;Shanghai Children Hospital of Fudan University,Shanghai 201102,China)

机构地区：[1]上海市闵行区妇幼保健院,上海201102 [2]上海市复旦大学附属儿科医院,上海201102

出　　处：《中国儿童保健杂志》2019年第5期495-498,526,共5页Chinese Journal of Child Health Care

基　　金：上海市闵行区科委基金(2015MHZ015)

摘　　要：目的运用倾向性评分匹配(PSM)法探讨辅助生殖技术(ART)对子代1岁内第二版Peabody运动发育量表(PDMS-2)评估结果的影响,为判断ART对子代运动发育的影响提供依据。方法 2014年12月-2018年4月收集在上海市闵行区于1岁内接受过PDMS-2评估,经家长知情同意采集完整信息,且评估前两周内未患肺炎、腹泻、发热等疾病,无先天性疾病等影响运动发育者为研究对象。对入组的自然受孕组216例和ART受孕组158例,运用PSM设置匹配容差为0.002 7进行1∶1匹配,匹配变量为"出生体重、孕周、胎数、性别、出生抢救史、黄疸、神经疾病和其它疾病史,父母亲的年龄、文化、职业,母亲孕期保胎、服药、糖尿病、高血压和其它疾病史,PDMS评估月龄",比较匹配后组间差异。结果匹配后,两组在"各匹配变量、粗大动作发育商、粗大动作各能区原始分、抓握能区原始分"间差异均无统计学意义(P>0.05),ART受孕组"精细运动发育商"及"视觉-运动整合能区原始分"均低于自然受孕组,差异有统计学意义(P<0.05)。结论 ART可能通过影响子代1岁内的"视觉-运动整合"能力降低其精细运动发育水平,其远期意义有待进一步研究。Objective To explore the impact of the assisted reproductive technology(ART) on the offspring infants′ assessment results of Peabody Developmental Motor Scale Ⅱ(PDMS-2) test by applying propensity score matching,in order to provide references for judging the effects of ART on offspring′s motor development. Methods Infants who had received PDMS-2 test without pneumonia,diarrhea,fever and other diseases within the last two weeks,and with no congenital diseases that affect motor development were selected in Minhang District of Shanghai from December 2014 to April 2018.The objects were divided into natural conceived group and ART conceived group,with 216 and 158 participants,respectively.The two groups were matched by applying one-to-one propensity score matching(PSM),setting the matching tolerance to 0.002 7.And the matching covariates included birth weight,gestational age,fetus number,gender,the history of rescue,jaundice,brain and other disease,parental age,education degree,occupation,maternal fetal history of miscarriage,medication,diabetes,hypertension and other diseases,and the assessment age of PDMS-2.The differences between natural conceived group and ART conceived group were compared before and after match. Results There was no statistical difference on all the matching variables,gross motor quotient,original score of each subtest of gross motor and grasp subtest between natural conceived group and ART conceived group after match(P>0.05).And the score of fine motor quotient and original score of visual motor integration subtest in ART group were significantly lower than those of natural conceived group(P<0.05). Conclusion ART may have lower fine motor quotient because of the negative influence of visual motor integration in infants,and further research is warranted.

关 键 词：倾向性评分匹配 辅助生殖技术 子代 PEABODY运动发育量表 

分 类 号：R179[医药卫生—妇幼卫生保健]