Intelligence, motoric and psychological outcomes in children from different ART treatments: a systematic review and meta-analysis

Journal of Neurodevelopmental Disorders

Review

Jenifer Kiem Aviani¹  Meita Dhamayanti²  Wiryawan Permadi³  Tono Djuwantono⁴  Danny Halim⁵  Tri Hanggono Achmad⁶ 

[1] Bandung Fertility Center, Limijati Mother and Child Hospital, Bandung, West Java, Indonesia;Department of Child Health, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia;Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia;Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia;Bandung Fertility Center, Limijati Mother and Child Hospital, Bandung, West Java, Indonesia;Research Center for Medical Genetics, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia;Research Center for Medical Genetics, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia;Department of Basic Medical Science, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia;

关键词: Assisted reproductive treatment;    In vitro fertilization;    Intracytoplasmic sperm injection;    Children neurodevelopment;    Intelligence quotient;    Motoric skills;    Behavioral problems;    Toddlers;    Preschool and primary school children;    Young adolescents;   

DOI  :  10.1186/s11689-023-09490-0

 received in 2022-05-31, accepted in 2023-06-27,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundSubtle abnormalities in children’s intelligence, motor skills, and psychology from various assisted reproductive treatments (ARTs) might be underdiagnosed. Understanding the prognosis of intelligence, motor skills, and psychology in children from ART would provide parents with reasonable expectations and enable them to plan relevant support to achieve the optimum potential in ART children.MethodsWe searched PubMed, EMBASE, Ovid, Google Scholar, and Scopus databases until April 13, 2021, to identify relevant studies. Thirty-four studies met the inclusion and exclusion criteria. The meta-analysis employed a standardized mean difference model. The outcome of this study is to compare intelligence quotient (IQ), motoric ability, and behavioral problems between all ARTs, in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI) to naturally conceived (NC) children. Subdomains of intelligence based on the Cattell, Horn, and Carroll Model (CHC Model) of cognitive architecture, including fluid reasoning, short-term and working memory, processing speed, visual-spatial ability, long-term memory retrieval, and crystalized intelligence (knowledge), were evaluated and summarized in details. Motor skill was stratified into two domains: gross motoric and fine motoric. Behavioral problem was categorized as externalizing and internalizing behavior.ResultsMeta-analysis showed that verbal intelligence score in IVF toddlers is significantly lower than NC toddlers (p = 0.02); conversely, ICSI toddlers scored significantly higher verbal intelligence score compared to NC toddlers (p = 0.005). Toddlers born after ART had significantly lower non-verbal intelligence score (p = 0.047). IVF toddlers scored significantly lower fine motor score (p = 0.01) compared to naturally conceived toddlers. Based on parent's CBCL, NC toddlers had higher total (p = 0.01) and externalizing behavior (p = 0.001) scores  compared to ART toddlers. Evaluation of full scale IQ and all domains of intelligence in preschool and primary school children revealed that no significant differences exist between ART and NC children. Based on preschool and primary school parents' CBCL, IVF children had significantly lower externalizing behavior score compared to NC children (p = 0.04). Meta-analyses of studies on young adolescents revealed that ART young adolescents scored higher academically than their NC counterparts, including on mathematics (p < 0.00001) and reading or language (p < 0.00001).ConclusionsDespite differences in certain aspects, this finding suggests that ART is unlikely to cause negative impacts on children’s neurodevelopment.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 6

Fig. 2

Fig. 11

40798_2023_622_Article_IEq19.gif

Fig. 4

Fig. 1