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目的探讨辅助受孕婴儿与自然受孕婴儿的新生情况以及12月龄时的精神运动发育水平有无差异。方法采用配对对照研究方法,将实验组与对照组母亲在年龄、产次、种族、地域、社会阶层、受教育程度等几个方面严格配对后,自母亲孕28周起入组登记并定期随访收集相关资料如婴儿胎龄、出生身长、出生体重、是否需要入住新生儿重症监护室(NICU)、有无出生缺陷等信息,出生后定期随访两组婴儿至12月龄时采用CDCC婴幼儿发育量表行精神运动发育评估。结果辅助受孕组婴儿出生时的身长、体重明显低于自然受孕组(P<0.01),且辅助受孕组婴儿中早产、低出生体重、新生儿期入住NICU等发生率也明显高于对照组(P<0.05),但在剔除两组人群中的双胎妊娠儿,只考虑单胎妊娠儿时,这些差异消失。另外,两组婴儿在12月龄时的智力发育指数(MDI)及运动发育指数(PDI)差异无显著性意义(P>0.05)。结论辅助生殖技术本身对婴儿的生长发育无明显影响,高发的双胎及多胎妊娠是引起辅助受孕儿有更差的新生情况的主要原因。故限制胚胎移植数量,降低双胎、多胎妊娠的发生率将成为保证辅助受孕子代生存质量的当务之急。
Objective To investigate whether there is any difference in the newborn status between infants conceived with conception and those conceived naturally and the level of mental activity at 12 months of age. Methods A pairwise control study was conducted. The mothers of the experimental group and the control group were matched with each other on the basis of age, parity, race, geography, social class, education level and so on. Relevant information such as baby’s gestational age, length of birth, birth weight, need for admission to NICU, birth defects and other information are collected. After birth, two groups of infants are regularly followed up to 12 months of age using CDCC infant development Mental Health Developmental Assessment. Results The birth weight and body weight of the assisted conception group were significantly lower than those of the spontaneous conception group (P <0.01). The incidences of premature birth, low birth weight and neonatal NICU admission in the assisted conception group were also significantly higher than those in the control group P <0.05). However, in the case of twin pregnancies excluding both groups, only differences in singleton pregnancies were considered, and these differences disappeared. In addition, there was no significant difference in mental development index (MDI) and motor development index (PDI) between the two groups at 12 months of age (P> 0.05). Conclusion Assisted reproductive technology itself has no significant effect on the growth and development of babies. High prevalence of twins and multiple pregnancies is the main cause of worse neonatal status in assisted conception. Therefore, limiting the number of embryo transfer and reducing the incidence of twins and multiple pregnancies will be the most urgent task to ensure the quality of life of assisted conception.