Effects of pregnancy planning, fertility, and assisted reproductive treatment on child behavioral problems at 5 and 7 years: evidence from the Millennium Cohort Study
Effects of pregnancy planning, fertility, and assisted reproductive treatment on child behavioral problems at 5 and 7 years: evidence from the Millennium Cohort Study
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DOI：
10.1016/j.fertnstert.2012.10.029
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发表时间：
2013-02-01
影响因子：
6.7
通讯作者：
Quigley, Maria A.
中科院分区：
文献类型：
--
作者：
Carson, Claire;Redshaw, Maggie;Quigley, Maria A.
目的：探讨妊娠计划、受孕时间(TTC)和辅助生殖技术(ART)对儿童行为的影响。设计：前瞻性队列研究。设置：不适用。患者(S)：在9个月时招募12,380名独生子女，并在5年和7年进行随访。受孕分为“未计划的”(未计划的，不快乐的)、“不合时宜的”(未计划的，快乐的)、“计划的”(计划的，TTC<；12个月)、“不育的”(计划的，TTC>；干预(S)：无干预。主要结局测量(S)：儿童行为(长处和困难问卷)。结果(S)：错时和计划外儿童在5岁和7岁时的SDQ平均得分高于计划组，且更有可能出现临床相关的行为问题。ART儿童在5岁和7岁时的平均SDQ得分均显著高于计划组。与临床相关的行为问题在5年时观察到增加(优势比2.05[95%可信区间0.96，4.42])，但未达到统计学意义。低生育组和促排卵组无明显影响。结论(S)：计划外和时机不正的儿童比计划的同龄人表现出更多的行为问题。虽然ART儿童的平均总困难分数更高，但这并没有转化为临床相关行为问题的统计显著增加。(Fertil Steril(R)2013；99：456-63。(C)2013年，由美国生殖医学学会颁发。)
Objective: To examine the effects of pregnancy planning, time to conception (TTC), and assisted reproductive technologies (ART) on child behavior.Design: Prospective cohort study.Setting: Not applicable.Patient(s): A total of 12,380 singletons recruited at 9 months and followed-up at 5 and 7 years. Conceptions were divided into "unplanned" (unplanned, unhappy), "mistimed" (unplanned, happy), "planned" (planned, TTC < 12 months), "subfertile" (planned, TTC >= 12 months), "ovulation induced" (received clomiphene citrate), and "ART" (IVF or intracytoplasmic sperm injection).Intervention(s): None.Main Outcome Measure(s): Child behavior (Strengths and Difficulties Questionnaire [SDQ]).Result(s): Mistimed and unplanned children had higher average SDQ scores at age 5 and 7 years and were significantly more likely to have a clinically relevant behavioral problem compared with the planned group. The ART children had significantly higher average SDQ scores at both 5 and 7 years compared with the planned group. An increase in clinically relevant behavioral problems was observed at 5 years (odds ratio 2.05 [95% confidence interval 0.96, 4.42]) but failed to reach statistical significance. No effects were observed in the subfertile and ovulation-induced groups.Conclusion(s): Unplanned and mistimed children exhibit more behavioral problems than their planned peers. Though ART children have higher mean total difficulties scores, this did not translate into a statistically significant increase in clinically relevant behavioral problems. (Fertil Steril (R) 2013; 99: 456-63. (C) 2013 by American Society for Reproductive Medicine.)