The growth of assisted reproductive treatment-conceived children from birth to 5 years: a national cohort study.
The growth of assisted reproductive treatment-conceived children from birth to 5 years: a national cohort study.
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DOI：
10.1186/s12916-018-1203-7
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发表时间：
2018-11-28
期刊：
影响因子：
9.3
通讯作者：
Brison DR
中科院分区：
文献类型：
--
作者：
Hann M;Roberts SA;D'Souza SW;Clayton P;Macklon N;Brison DR
出生体重和儿童早期生长是长期心脏代谢疾病风险的重要预测因素，符合健康和疾病的发育起源假说。由于人类辅助生殖技术（ART）发生在敏感的围孕期发育窗口期，因此调查 ART 受孕儿童的风险最近已成为当务之急。我们对 ART 儿童从出生到学龄的早期生长进行了首次大规模全国队列研究，将英国人类受精和胚胎学管理局持有的 ART 登记册与苏格兰妇幼健康数据库联系起来。在这项针对 5200 名 ART 和 20,800 名自然受孕 (NC) 对照儿童的研究中，线性回归分析显示，新鲜胚胎移植周期出生的婴儿的出生体重比 NC 对照低 93.7 g [95% CI (76.6, 110.6)g]，而冷冻胚胎移植 (FET) 周期出生的婴儿的出生体重为 57.5 g [95% CI (30.7, 86.5)g]更重。新鲜 ART 婴儿从出生起生长速度更快（每周增加 7.2 克），但在 6-8 周时仍然比 NC 婴儿轻（减少 171 克），比 FET 婴儿小 133 克； FET 和 NC 婴儿相似。长度和枕额周长遵循相同的模式。按入学年龄（4-7 岁）计算，通过新鲜 ART 和 FET 怀上的男孩和女孩的体重、身长和体重指数与 NC 儿童相似。与 NC 和 FET 婴儿相比，通过新鲜胚胎移植出生的 ART 婴儿在子宫内和生命的最初几周内生长较慢，但到了学龄期则表现出产后追赶性生长。由于低出生体重和产后追赶是生命过程中心脏代谢疾病的独立危险因素，我们建议现在有必要在这一领域进行进一步的研究。本文的在线版本 (10.1186/s12916-018-1203-7) 包含补充材料，可供授权用户使用。
Birth weight and early child growth are important predictors of long-term cardiometabolic disease risk, in line with the Developmental Origins of Health and Disease hypothesis. As human assisted reproductive technologies (ARTs) occur during the sensitive periconceptional window of development, it has recently become a matter of urgency to investigate risk in ART-conceived children. We have conducted the first large-scale, national cohort study of early growth in ART children from birth to school age, linking the register of ART, held by the UK’s Human Fertilisation and Embryology Authority, to Scottish maternity and child health databases. In this study of 5200 ART and 20,800 naturally conceived (NC) control children, linear regression analysis revealed the birthweight of babies born from fresh embryo transfer cycles is 93.7 g [95% CI (76.6, 110.6)g] less than NC controls, whereas babies born from frozen embryo transfer (FET) cycles are 57.5 g [95% CI (30.7, 86.5)g] heavier. Fresh ART babies grew faster from birth (by 7.2 g/week) but remained lighter (by 171 g), at 6–8 weeks, than NC babies and 133 g smaller than FET babies; FET and NC babies were similar. Length and occipital-frontal circumference followed the same pattern. By school entry (4–7 years), weight, length and BMI in boys and girls conceived by fresh ART and FET were similar to those in NC children. ART babies born from fresh embryo transfer grow more slowly in utero and in the first few weeks of life, but then show postnatal catch up growth by school age, compared to NC and FET babies. As low birth weight and postnatal catch-up are independent risk factors for cardiometabolic disease over the life-course, we suggest that further studies in this area are now warranted. The online version of this article (10.1186/s12916-018-1203-7) contains supplementary material, which is available to authorized users.
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