辅助生殖技术受孕单胎早产儿出生结局和认知发育的纵向研究  

Longitudinal study on the birth outcome and cognitive development of singleton preterm infants conceived by assisted reproduction technology

作　　者：胡丹 汪晓霞 崔一帆 刘璞 梁倩 肖绪武 HU Dan;WANG Xiao-xia;CUI Yi-fan;LIU Pu;LIANG Qian;XIAO Xu-wu(Dalian Women and Children's Medical Center(Group),Dalian,Liaoning 116083,China)

机构地区：[1]大连市妇女儿童医疗中心(集团),辽宁大连116083

出　　处：《中国儿童保健杂志》2022年第6期669-672,共4页Chinese Journal of Child Health Care

基　　金：辽宁省自然基金指导计划项目(2019-ZD-1017);大连市科技创新基金计划项目(2019J13SN81)。

摘　　要：目的 分析辅助生殖技术(ART)受孕单胎早产儿与自然受孕(NC)单胎早产儿出生结局、婴儿期认知发育水平的差异,为ART受孕单胎早产儿的早期全面健康发展指导提供科学依据。方法 2019年1月1日—2021年7月31日期间纳入28例ART早产儿与34例NC早产儿并收集相关信息,并于6月龄、12月龄进行体格检查和儿童神经心理行为发育测评(儿心-2016版)。结果 ART单胎早产儿父母生育年龄(t=2.536、2.055)、妊娠合并症发生率(χ^(2)=11.442)、剖宫产率(χ^(2)=6.115)、低出生体重率(χ^(2)=4.736)均高于NC组,差异有统计学意义(P<0.05),但两组早产儿出生体重、身长以及6月龄和12月龄身长、体重及增长值的差异均无统计学意义(P>0.05)。ART单胎早产儿6月龄总发育商、精细运动、语言发育商(92.23±8.15、88.38±7.64、89.95±12.35)均低于NC组,警示行为发育商(3.57±3.12)高于NC组,差异均有统计学意义(t=2.376、2.163、2.142、2.467,P<0.05);12月龄时两组早产儿认知发育的差异均无统计学意义(P>0.05)。结论 ART受孕单胎早产儿胎儿期面临更多不良高危因素,婴儿期体格发育水平与NC类似,婴儿早期应加强精细运动和语言能力促进,注意孤独症可疑行为筛查,以促进其早期全面发展。Objective To compare the birth outcome and cognitive development level of singleton preterm infants conceived by assisted reproductive technology(ART) with those of healthy infants naturally conceived, so as to provide scientific basis for the early comprehensive development of ART preterm infants. Methods A total of 28 ART singleton preterm infants and 34 NC singleton preterm infants were enrolled in this study from January 1 st, 2019 to July 31 st, 2021, and their relevant information were collected. Children′s Neuropsychological Behavioral Development Assessment(2016 version) was conducted in all subjects at 6 and 12 months old. Results Maternal and paternal age for childbearing(t=2.536,2.055), the rates of pregnancy complications(χ^(2)=11.442), cesarean section(χ^(2)=6.115) and low birth weight(χ^(2)=4.736) of ART preterm infants were all significantly higher than those of NC infants(P<0.05). ART group and NC group had similar physical development levels and trends at birth, 6 months old and 12 months old(P>0.05). The total development quotient, the scores of fine motor development and language development at 6 months old of ART preterm infants were 92.23±8.15, 88.38±7.64, 89.95±12.35, significantly lower than those in NC group, while the score of warning behavior(3.57±3.12) was significantly higher(t=2.376, 2.163, 2.142, 2.467, P<0.05). But the cognitive development levels of the two groups were similar at the age of 12 months(P>0.05). Conclusions ART singleton preterm infants have more adverse high-risk factors during the fetal period, but the physical development reaches the level of naturally conceived infants. The health promotion of fine motor and language skills should be strengthened, as well as the behavior screening for autism in the early infancy of ART infants, so as to promote their early and comprehensive development.

关 键 词：辅助生殖技术 早产儿 婴儿期 认知发育 单胎 

分 类 号：R722.6[医药卫生—儿科]