Perinatal Outcome and Follow-up of Children Born from ART
The widespread application of new reproduction techniques has led to concern not only about the course of such pregnancies but also about the offspring’s health and postnatal development.
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The widespread application of new reproduction techniques has led to concern not onlyy about the course of such pregnancies but also about the offspring’s health and postnatal development. Several studies have been reported examining the incidence of chromosomal anomalies, congenital malformations f and child development after f assisted reproduction. Lancaster states that advanced parental age (chromosomal abnormalities with advanced maternal age and point mutations with advanced paternal age), underlying causes of infertility, y drugs such as clomiphene and IVF procedures (e.g. freezing and thawing) are factors that might influence the risk of chromosomal abnormalities and congenital malformations (Lancaster 1985). The high incidence of multiple births with the risk of prematurityy and adverse health outcomes such as low birth weight, respiratory distress syndrome, need ffor ventilation, intraventricular haemorrhage or retinopathy, h might seriously endanger the offspring’s f postnatal development. The literature on the health and development of these children is reviewed in this chapter. For a better understanding of the data, we have subdivided the presentation into non-controlled and controlled studies.
Descriptive Studies Without Control Groups Yovich et al. assessed the development of the ffirst 20 inffants resulting ffrom IVF Y in Western Australia at their first f birthday ay, including one pair of twins and two sets of triplets (Yovich et al. 1986). Their development status was measured on the Griffith Development Scales for children. All infants had progressed normally, y and for five test scales their developmental assessment was in advance of the mean rates. The authors point out, however, that it cannot be concluded that these children had advanced development, as a control series was not studied. A non-controlled study by Mushin et al. examined 33 children resulting fro f m IVF aged between 12 and 37 months as to their early psychosocial development which was assessed using the Bayley Scales of Infant f Development (Mushin et al. 1986). Overall scores were within the normal range and problems presented were in accordance with the high incidence of prematurityy (21.2%) and twins (36.4%) in the studied group of children. Wennerholm et al. performed a follow-up of 95 children resulting from IVFET from 18 months up to 8 years (Wennerholm et al. 1991). Of the 95 children, M. Ludwig, Pregnancy and Birth after Assisted Reproductive Technologies © Springer-Verlag Berlin Heidelberg 2002
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Perinatal Outcome and Follow-up of Children Born from ART R
Table 8.1. Perinatal outcome and fo T f llow-up of children born after f ART. Descriptive studies without control groups Study
No. of children
ART
Age of children (months)
Tests
Results
Yovich et al. 1986 Mushin et al. 1986 Wennerholm et al. 1991
20 33 95
IVF IVF IVF
12 12–37 18
Griffith Scales Bayley Scales Physica h l development
No difference No difference Long-term sequelae associated with immaturity/ birth weight
88 appeared completely health
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