Cognitive development of singletons born after intracytoplasmic sperm injection compared with in vitro fertilization and natural conception
Cognitive development of singletons born after intracytoplasmic sperm injection compared with in vitro fertilization and natural conception
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DOI：
10.1016/j.fertnstert.2007.06.090
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发表时间：
2008-08-01
影响因子：
6.7
通讯作者：
Veen, Sylvia
中科院分区：
文献类型：
--
作者：
Knoester, Marjolein;Helmerhorst, Frans M.;Veen, Sylvia
目的：探讨5 ~ 8岁单胎卵胞浆内单精子注射（ICSI）的认知发育情况。设计：随访研究。地点：大学医疗中心，2004年3月至2005年5月评估。患者：将1996年6月至1999年12月在莱顿大学医学中心ICSI后出生的单胎与IVF和自然受孕（NC）后出生的匹配单胎进行比较。干预：受孕方式。主要结果测量：智商（IQ）测量与修订阿姆斯特丹儿童智力测验（简称）。调查人员对受孕方式不知情。结果：ICSI孕育的单胎（n = 83）的智商得分低于IVF孕育的单胎（n = 83）（调整后的平均智商差：3.6[95%置信区间(CI) -0.8, 8.0j）。在对智商结果进行分类后（115），没有发现智商分布的显著差异。ICSI孕育的独生子女（n = 86）的智商得分低于NC孕育的独生子女（n = 85）；根据模型中包含的协变量，调整后的平均差异在5到7点之间（5.6 [95% CI 0.9, 10.31; 7.1 [95% CI 1.7, 12.5]）。对早产进行调整并没有改变结果。IQ类别115的百分比分别为ICS的12%，64%和24%，NC的6%，54%和40%。结论：在相对有限的调查样本中，ICSI单胎的认知发育低于IVF和NC单胎。不孕因素或未测量的混杂因素可能起作用。
Objective: To investigate cognitive development of singletons conceived by intracytoplasmic sperm injection (ICSI) at 5-8 years of age.Design: Follow-up study. Setting: University medical center, assessments between March 2004 and May 2005.Patient(s): Singletons born between June 1996 and December 1999 after ICSI at the Leiden University Medical Center were compared with matched singletons born after IVF and natural conception (NC). Intervention(s): Mode of conception.Main Outcome Measure(s): Intelligence quotient (IQ) was measured with the Revised Amsterdam Child Intelligence Test (short form). The investigators were blinded to conception mode.Result(s): Singletons conceived by ICSI (n = 83) achieved lower IQ scores than IVF singletons (n = 83) (adjusted mean difference IQ: 3.6 [95% confidence interval (CI) -0.8, 8.0j). After categorizing IQ outcomes ( 115), no significant difference in the distribution of IQ was found. Singletons conceived by ICSI (n = 86) achieved lower IQ scores than NC singletons (n = 85); the adjusted mean difference varied between 5 and 7 points (5.6 [95% CI 0.9, 10.31; 7.1 [95% CI 1.7, 12.5]) depending on the covariates included in the model. Adjustment for prematurity did not change the results. Percentages in IQ categories 115 were 12%, 64%, and 24% for ICS] and 6%, 54%, and 40% for NC, respectively.Conclusion(s): In the relatively limited sample investigated, cognitive development among ICSI singletons was lower than among IVF and NC singletons. Infertility factors or unmeasured confounders may play a role.