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目的探讨辅助生殖技术(assisted reproductive technology,ART)对子代远期运动发育结局的影响。方法选取2009年1-12月在南京市妇幼保健院生殖医学中心进行卵胞浆内单精子注射(intracytoplasmic sperm injection,ICSI)的单胎活产子代18例为研究对象(ICSI),以年龄、性别、胎数为匹配条件,选取在南京市妇幼保健院出生的活产婴儿36例为对照组(NC),排除孕周<32周,体重<1 500g,有宫内窘迫,出生窒息史者进行研究。利用儿童运动评估系列(Movement Assessment Battery for Children,M-ABC)量表和儿童感觉统合发展检核表(3~6岁)分别比较两组儿童4岁龄的运动及感觉统合能力发育结局。结果体格发育:ICSI子代出生身长[ICSI:(48.72±2.52)cm,NC:(50.33±1.24)cm]、出生体重[ICSI:(3.04±0.68)kg,NC:(3.50±0.42)kg]均低于对照组,差异有统计学意义(P<0.05);4岁龄,两组的身高、体重及头围均无统计学差异;运动发育:两组在手灵巧度、目标/抓握运动及总分方面无统计学差异(P均>0.05);在平衡能力(ICSI:8.44±1.72,NC:10.92±3.18)方面,ICSI组能力低于对照组,差异有统计学意义(P<0.05)。感觉统合能力:两组在前庭平衡和大脑双分化情况、触觉防御、发育期运用障碍、视觉空间和形状感觉、重心、整体评估差异均无统计学意义(P均>0.05)。结论通过细化评估内涵、扩大样本量和延长随访时间可以为辅助生殖子代远期发育结局的判断提供更有力的证据。
Objective To investigate the effect of assisted reproductive technology (ART) on the long-term developmental outcome of offspring. Methods Twenty-one live births with intracytoplasmic sperm injection (ICSI) from January 2009 to December 2009 in the Reproductive Medicine Center of Nanjing MCH were enrolled as study objects (ICSI). The age, Gender and number of fetuses were matching conditions. Thirty-six live births born in Nanjing MCH were selected as control group (NC), excluding gestational age <32 weeks, body weight <1 500g, history of intrauterine distress and birth asphyxia research. The motor and sensory integration ability developmental outcomes of children aged 4 years were compared using the MAS (Child Assessment Series for Children, M-ABC) Scale and Children’s Sensory Integration Development Checklist (3-6 years old). RESULTS: Physical development: ICSI: (48.72 ± 2.52) cm, birth weight (ICSI: (3.04 ± 0.68) kg, NC: (3.50 ± 0.42) (P <0.05); 4-year-old, there was no significant difference in height, weight and head circumference between the two groups; exercise development: dexterity in both hands, target / grip There was no significant difference in exercise and total scores (P> 0.05). The ICSI group’s ability to balance (ICSI: 8.44 ± 1.72, NC: 10.92 ± 3.18) was lower than that of the control group (P < 0.05). Sensory integration: There were no significant differences between the two groups in vestibular balance and brain dual differentiation, tactile defense, dysplastic barriers, visual space and shape, center of gravity and overall evaluation (all P> 0.05). Conclusion The refinement of the assessment of connotation, expansion of sample size and prolonged follow-up time can provide more powerful evidence for the judgment of long-term developmental outcome of assisted reproductive offspring.