辅助生殖技术子代4岁龄运动发育结局分析

【作者】 洪琴； 池霞； 杨蕾； 张敏； 刘晓； 戴家政； 解雅春； 姚天红； 俞倩； 潘丽朝； 陈荣华； 郭锡熔； 童梅玲；

【机构】 生殖医学国家重点实验室,南京医科大学附属南京妇幼保健院； 南京医科大学儿科医学研究所；

【摘要】 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01月至2009年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 In.jeetion,ICSI)的单胎活产子代18例为研究对象(A),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(C),排除孕周<32w,体重<1500g,有宫内窘迫,出生窒息史者进行研究。利用M-ABC量表和儿童感觉统合量表分别比较两组儿童4岁龄的运动及感觉统合能力发育结局。结果:①体格发育:ART子代出生身长(A:48.72±2.52,C:50.33±1.24)、出生体重(A:3.04±0.68,C:3.50±0.42)均显著低于对照组,p<0.05;4岁龄,两组的身高(A:106.55±4.46,C:107.44±3.80)、体重(A:17.83±2.93,C:18.58±3.37)、头围(A:50.44±1.52,C:50.42±1.48)均无显著性差异,p>0.05;②运动发育:两组在灵活性(A:10.39±1.91,C:10.47±3.75),手眼协调(A:8.50±2.62,C:8.33±2.69)及总分(A:8.94±1.96,C:9.72±2.16)方面无显著性差异,p>0.05;在平衡性(A:8.44±1.72,C:10.92±3.18)方面,ART组显著低于对照组,p<0.05。③感觉统合能力:两组在前庭平衡和大脑双分化情况(A:51.00±6.82,C:51.22±11.23)、触觉防御(A:51.78±6.612,C:55.61±11.32)、发育期运用障碍(A:50.44±10.89,C:52.86±9.89)、视觉空间和形状感觉(A:51.39±8.35,C:53.83±9.13)、重心(A:54.6l±7.80,C:55.03±11.00)、整体评估(A 53.28±7.53,C:54.81±10.56)均无显著性差异,p>0.05。结论:辅助生殖技术子代总体大运动及感觉统合能力发育与对照组无显著差别,但平衡性方面较对照组能力弱,提示对其发育结局的判定需要更加细化的评估。更多还原

【Abstract】 Aim:The purpose of this study was to assess the motor developmental outcome at 4 year of children conceived by ICSI and to compare with children conceived naturally.Methods:Children enrolled into our study were conceived by ICSI from Jan,2009,through to the end of Dec 2009 in the State key Laboratory of Reproductive Medicine Department of Nanjing Maternity and Child Health Care Hospital.18 ICSI alive single born underwent movement assessments and 36 NC control subjects were matched with respect to age,gender,and birth number.The children were excluded if their gestational weeks less than 32 weeks,birth weight less than 1500 g,with fetal distress or birth asphyxia history.Children’ s motor development was assessed with the Movement Assessment Battery of Children(M-ABC) and children sensory integration scale,respectively.Result:We found ① The ART offspring birth length(A:48.72 + 2.52,C:50.33 + 1.24),birth weight(A:3.04 ± 0.68,C:3.50 ± 0.42) was significantly lower than the control group;4 years old,no significant difference was found in the height of the two groups(A:106.55 ± 4.46,C:107.44 ± 3.80),weight(A:17.83+ 2.93,C:18.58 ± 3.37),head circumference(A:50.44 + 1.52,C:50.42± 1.48),p> 0.05;(2) motor development:there was no different in terms of flexibility(A:10.39 ± 1.91,C:10.47 ± 3.75),hand-eye coordination(A:8.50 ± 2.62,C:8.33 ± 2.69 no 9.72 ± 2.16),and total score(A:8.94 ± 1.96,C 8.44 ±1.72),p> 0.05;in balance(A:8.44±1.72,C:10.92 ± 3.18),ART group was significantly lower than the control group,p <0.05.(3) sensory integration capabilities:there was no different in balance and vestibular double differentiation of the brain(A:51.00 ±6.82,C:51.22 ± 11.23),tactile defensiveness(A:51.78 ± 6.612,C:55.61 ± 11.32),developmental dyspraxia(A:50.44 ± 10.89,C:52.86 ±9.89),visual-spatial and shape sensory(A:51.39 ± 8.35,C:53.83 ±9.13),the center of gravity(A:54.61 ± 7.80,C:55.03 ± 11.00),overall evaluation(a:53.28 ±7.53,C:54.81 ± 10.56),p> 0.05.Conclusion:no significant difference was found in overall gross motor development and sensory integration capabilities between ARTs offspring and the control group,but the balance abilities of ARTs offspring were weaker than the control group,suggesting that more refined assessment was necessary for their developmental outcomes.更多还原