目的:冷冻胚胎移植(FET)后出生的单胎儿童之间是否存在生长差异,新鲜胚胎移植(ET),和自然受孕(NC)?
结论:FET后出生的青春期男孩与新鲜ET后出生的男孩相比,平均比例更高,超重几率增加。
背景:与新鲜ET和NC后出生的孩子相比,FET后出生的孩子平均出生体重更高,胎龄大的风险增加。这引发了关于童年后期可能的生长差异的问题。先前关于FET后儿童生长的研究报告了部分相互矛盾的结果,并且缺乏直到青春期的长期数据。
方法:这是一项基于国家人口登记的队列研究,芬兰医疗出生登记册和初级卫生保健访问登记册,包括FET后出生的单身人士(n=1825),新鲜ET(n=2933),1995年至2006年期间,芬兰的NC(n=31136)。
方法:比较两组之间的超重比例(即年龄和性别调整的ISO-BMI≥25儿童)。计算超重的赔率比(ORs)和调整后的赔率比(aORs)。对出生年份进行了调整,早产,产妇年龄,奇偶校验,和社会经济地位。平均高度,重量,每年在7至18岁之间的组间比较BMI。
结果:FET男孩超重的平均比例(28%)高于新鲜ET(22%,P<0.001)和NC(26%,P=0.014)男孩。对于所有年龄段的人来说,与新鲜ET男孩相比,FET男孩的超重aOR增加(1.14,95%CI1.02-1.27)。对于女孩来说,超重的平均比例为18%,19%,FET后出生的人占22%,新鲜的ET,NC,分别(FET与新鲜ET的P=0.169,FET对NC的P<0.001)。对于所有年龄段的人来说,与NC女孩相比,FET女孩的超重aOR降低(0.89,95%CI0.80-0.99)。在不同年龄段,有6.9%至30.6%的FET男孩和4.7%至29.4%的FET女孩可进行生长测量。
结论:不幸的是,我们无法调整父母的人体测量特征。整个队列的生长数据不可用,在随访开始和结束时,有可用测量值的儿童比例有限.在学习期间,主要是卵裂期胚胎被转移,缓慢冷冻用于ART。
结论:FET男孩超重的风险值得进一步研究。未来的研究应旨在调查解释这一性别特异性发现的机制,并将生长数据与长期健康数据相结合,以探索成年后超重和心脏代谢疾病的可能风险。
背景:资金来自Päivikki和SakariSohlberg基金会,Alma和K.A.Snellman基金会(对A.M.T.的个人资助),和芬兰政府研究基金。资金来源不参与研究的计划或执行。作者声明没有利益冲突。
背景:不适用。
OBJECTIVE: Are there growth differences between singleton children born after frozen embryo transfer (FET), fresh embryo transfer (ET), and natural conception (NC)?
CONCLUSIONS: Adolescent boys born after FET have a higher mean proportion and increased odds of overweight compared to those born after fresh ET.
BACKGROUND: Children born after FET have higher mean birthweights and an increased risk of large-for-gestational-age compared to those born after fresh ET and even NC. This raises questions about possible growth differences later in childhood. Previous studies on child growth after FET report partly conflicting results and lack long-term data until adolescence.
METHODS: This was a cohort study based on national population-based registers, the Finnish Medical Birth Register and the Register of Primary Health Care visits, including singletons born after FET (n = 1825), fresh ET (n = 2933), and NC (n = 31 136) in Finland between the years 1995 and 2006.
METHODS: The proportions of overweight (i.e. age- and sex-adjusted ISO-BMI for children ≥ 25) were compared between the groups. Odds ratios (ORs) and adjusted odds ratios (aORs) of overweight were calculated. Adjustments were made for birth year, preterm birth, maternal age, parity, and socioeconomic status. Mean heights, weights, and BMIs were compared between the groups each year between the ages of 7 and 18.
RESULTS: FET boys had a higher mean proportion of overweight (28%) compared to fresh ET (22%, P < 0.001) and NC (26%, P = 0.014) boys. For all ages combined, the aOR of overweight was increased (1.14, 95% CI 1.02-1.27) for FET boys compared to fresh ET boys. For girls, the mean proportions of overweight were 18%, 19%, and 22% for those born after FET, fresh ET, and NC, respectively (P = 0.169 for FET vs fresh ET, P < 0.001 for FET vs NC). For all ages combined, FET girls had a decreased aOR of overweight (0.89, 95% CI 0.80-0.99) compared to NC girls. Growth measurements were available for 6.9% to 30.6% of FET boys and for 4.7% to 29.4% of FET girls at different ages.
CONCLUSIONS: Unfortunately, we were not able to adjust for parental anthropometric characteristics. The growth data were not available for the whole cohort, and the proportion of children with available measurements was limited at the start and end of the follow-up. During the study period, mainly cleavage stage embryos were transferred, and slow freezing was used for ART.
CONCLUSIONS: The risk of overweight among FET boys warrants further research. Future studies should aim to investigate the mechanisms that explain this sex-specific finding and combine growth data with long-term health data to explore the possible risks of overweight and cardiometabolic disease in adulthood.
BACKGROUND: Funding was obtained from the Päivikki and Sakari Sohlberg Foundation, the Alma and K.A. Snellman Foundation (personal grants to A.M.T.), and the Finnish Government Research Funding. The funding sources were not involved in the planning or execution of the study. The authors declare no conflicts of interest.
BACKGROUND: N/A.