Cognitive development in children up to age 11 years born after ART-a longitudinal cohort study.
Cognitive development in children up to age 11 years born after ART-a longitudinal cohort study.
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DOI：
10.1093/humrep/dex102
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发表时间：
2017-07-01
期刊：
影响因子：
--
通讯作者：
Mills MC
中科院分区：
文献类型：
--
作者：
Barbuscia A;Mills MC
ART（IVF和ICSI）后受孕的儿童的认知发展-在3岁，5岁，7岁和11岁时测量认知技能-与自然受孕（NC）后出生的儿童有何不同？与NC相比，ART受孕的儿童在5岁以下的认知发育指标得到了改善，NC的认知发育指标下降了11年，ART儿童的得分仍略高于NC儿童。ART后受孕的儿童的认知结果是高度矛盾的。一些研究表明，抗逆转录病毒疗法儿童的行为、社会情感和认知发展受损，患精神障碍的风险更高。其他人报告没有增加风险或差异。认知发育以前没有使用3至11岁的潜伏生长曲线模型进行过检查，也包括适当注意混淆父母的特征。使用了英国千禧年队列研究前五波（2000-2012年）的纵向数据，这是一个两阶段的样本，来自社会保障儿童福利登记处的2000-2001年出生的所有婴儿，9个月大时居住在英国。最终样本N = 15 218名儿童（125 IVF和61 ICSI），来自14 816个家庭。8298名儿童可获得所有波的信息。2003年、2005年、2007年和2012年又进行了四次后续调查。我们的样本包括在一个联盟（已婚或同居父母）内出生的儿童，并且至少有两个测量点的认知评分信息。认知发展与英国能力量表进行了评估。在3岁和5岁时（第2波和第3波），儿童完成了命名词汇部分，该部分测量了语言表达能力。在7岁时（第4波），通过单词阅读测试评估言语认知能力，在11岁时（第5波）通过言语相似性测试评估言语认知能力。双尾Student t检验检查ART组和NC组之间的差异。生长曲线模型（随机系数，潜在轨迹模型）被用来研究ART的影响，混淆父母的特征和出生时的健康结果，在3岁时的认知能力的基线水平和其生长速度。在3岁和5岁时，辅助生殖技术受孕的儿童的言语认知能力高于正常儿童（P < 0.001），但随着时间的推移，这种能力一直下降，到11岁时下降。父母的环境和资源对儿童的认知发展至关重要。与NC儿童（N = 10 496-11 955）相比，ART儿童队列的样本量在每个时间段（N = 150-180）较小。由于样本量有限，我们也无法比较IVF与ICSI治疗。随着IVF和ICSI的使用越来越多，这些结果表明，对11岁以下儿童的早期认知结果没有不利影响，并强调了父母特征的重要性。该项目的资金来自欧洲联盟第七框架方案（FP 7 2007-2013）（第320116号家庭和社会）、ESRC/NCRM SOCGEN赠款（ES/N 0011856/1）和SOCIOGENOME ERC巩固者赠款（ERC-2013-CoG-615603）（给M.C.M.）。两位作者没有利益冲突需要声明。N/A.
How does the cognitive development of children conceived after ART (IVF and ICSI) – measured as cognitive skills at age 3, 5, 7 and 11 years – differ over time from those born after natural conception (NC)? Improved measures of cognitive development up to age 5 years were recorded in children conceived with ART compared to NC, which attenuates by 11 years, with ART children still scoring slightly better than NC children. Results on the cognitive outcomes of children conceived after ART have been highly contradictory. Some have shown that ART children have an impaired behavioural, socio-emotional and cognitive development and higher risk of mental disorders. Others have reported no increased risk or difference. Cognitive development has not been previously examined using latent growth curve models from ages 3 to 11 years, also including appropriate attention to confounding parental characteristics. Longitudinal data for the first five waves (2000–2012) of the UK Millennium Cohort Study were used, which is a two-stage sample of all infants born in 2000–2001 and resident in the UK at 9 months of age, drawn from the Department of Social Security Child Benefit Registers. A final sample of N = 15 218 children (125 IVF and 61 ICSI), from 14 816 families was used. Information was available for all waves for 8298 children. Four additional follow-up surveys were conducted in 2003, 2005, 2007 and 2012. Our sample includes children born within a union (married or cohabiting parents) and where information on cognitive scores was available for at least two measurement points. Cognitive development was assessed with the British Ability Scales. At age 3 and 5 years (wave 2 and 3), children completed the naming vocabulary component, which measures expressive verbal ability. At age 7 years (wave 4), verbal cognitive abilities were assessed through the word reading test, and at age 11 years (wave 5) through a verbal similarity test. Two-tailed Student's t-tests examined differences between ART and NC groups. Growth curve models (random-coefficient, latent trajectory models) were used to study the effect of ART, confounding parental characteristics and health outcomes at birth, both at a baseline level of cognitive ability at age 3 years and on its growth rate. At age 3 and 5 years, children conceived with the aid of ART have higher verbal cognitive abilities than NC children (P < 0.001) but this consistently decreases over time and diminishes by age 11 years. Parental environment and resources are pivotal in children's cognitive development. The sample size of the ART cohort of children is small across each time period (N = 150–180) in comparison with NC children (N = 10 496–11 955). Owing to a limited sample size, we are also unable to compare IVF versus ICSI treatment. With the increasing use of IVF and ICSI, these results indicate that there are no detrimental effects on children's early cognitive outcomes up to age 11 years, and highlight the importance of parental characteristics. Funding for this project was provided by the European Union's Seventh Framework Program (FP7 2007–2013) (No. 320116 Families and Societies), ESRC/NCRM SOCGEN Grant (ES/N0011856/1) and the SOCIOGENOME ERC Consolidator Grant (ERC-2013-CoG-615603) (to M.C.M.). The authors have no competing interests to declare. N/A.
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影响因子：
6.7
作者：
Gibson, FL;Ungerer, JA;Saunders, DM
通讯作者：
Saunders, DM
DOI：
10.1136/bmj.d4473
发表时间：
2011-07-26
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Carson C;Kelly Y;Kurinczuk JJ;Sacker A;Redshaw M;Quigley MA
通讯作者：
Quigley MA
影响因子：
6.1
作者：
Leunens, L.;Celestin-Westreich, S.;Ponjaert-Kristoffersen, I.
通讯作者：
Ponjaert-Kristoffersen, I.
影响因子：
6.7
作者：
Knoester, Marjolein;Helmerhorst, Frans M.;Veen, Sylvia
通讯作者：
Veen, Sylvia
影响因子：
3.5
作者：
McLanahan, S
通讯作者：
McLanahan, S