摘要
辅助生殖技术(assisted reproductive technology,ART)是近年来生殖医学领域的一项关键技术,为众多不孕不育夫妇提供了实现生育的可能。随着该技术的广泛应用,ART子代的近远期健康受到广泛关注。该文从人群和机制研究两方面综合评述了ART对子代神经发育(包括神经发育表现和神经发育障碍性疾病)的潜在影响。现有证据表明,ART子代早期神经发育表现落后与多胎、早产及低出生体重等因素相关性更强,尚无较强证据表明ART技术本身的直接影响,且随着儿童神经心理的快速发展,ART子代与自然妊娠子代的差异逐渐减小。此外,大量证据表明ART夫妇的不良生殖生育特征和产科不良结局可能是导致子代神经发育障碍性疾病风险增加的主要原因。但已有机制研究提出了ART诱导表观遗传紊乱的观点,表观遗传改变或与ART子代智力障碍、多动症、癫痫等神经发育障碍性疾病的发生有关。该文旨在为患者以及相关临床和科研工作者提供更为全面的相关知识,并持续推动该领域对ART安全性和技术优化的进一步思考。
ART(assisted reproductive technology)has emerged as a pivotal technique in reproductive medicine in recent years,offering an opportunity to parenthood for numerous infertile couples.As the application of ART becomes more widespread,the short-term and long-term health outcomes of children conceived through ART have garnered extensive attention.This article provides a comprehensive review of the potential impacts of ART on the neurodevelopment of offspring,encompassing both population-based and mechanistic studies.The current body of evidence suggests that early neurodevelopmental delays observed in ART-conceived children are more strongly associated with factors such as multiple gestations,preterm birth,and low birth weight,rather than ART procedures.With rapid neurodevelopment in early life,the disparities between ART-conceived and naturally conceived children gradually diminish.Additionally,many studies suggest that the increased risk of neurodevelopmental disorders in ART offspring are primarily attributable to adverse reproductive characteristics and obstetric outcomes of couples undergoing ART.However,existing mechanistic studies have proposed that ART-induced epigenetic dysregulation may play an important role in the impaired neurodevelopment in ART offspring,such as intellectual disabilities,ADHD(attention deficit hyperactivity disorder),and epilepsy.This article aims to provide patients,clinicians,and researchers with a more comprehensive understanding of neurodevelopment in ART offspring,and to continuously encourage further emphasis on the safety and technological optimization of ART within the field.
作者
庞丽雅
林苑
PANG Liya;LIN Yuan(State Key Laboratory of Reproductive Medicine and Offspring Health,Nanjing Medical University,Department of Maternal,Child and Adolescent Health,School of Public Health,Nanjing Medical University,Nanjing 211166,China)
出处
《中国细胞生物学学报》
CAS
CSCD
2024年第4期826-837,共12页
Chinese Journal of Cell Biology
基金
国家自然科学基金(批准号:82373581)
国家重点研发计划(批准号:2021YFC2700705)资助的课题。
关键词
辅助生殖技术
神经发育表现
神经发育障碍性疾病
表观遗传
assisted reproductive technology
neurodevelopmental manifestations
neurodevelopmental disorders
epigenetics
作者简介
通信作者:林苑,南京医科大学生殖医学与子代健康全国重点实验室项目负责人,南京医科大学公共卫生学院教授,博士生导师。江苏省特聘教授。2017年毕业于南京医科大学,获流行病学与卫生统计学博士学位。先后在美国印第安纳大学公共卫生学院和美国国立卫生院儿童健康和人类发展研究所开展博士后研究。2018年任美国印第安纳大学公共卫生学院流行病学系助理教授(tenure-track),2020年任职南京医科大学。研究方向为生殖与子代健康队列研究,获聘江苏省特聘教授,主持国家自然科学基金项目2项,科技部重点研发项目课题1项。研究成果以通讯或第一作者发表于Nat Genet、Nat Commun、AJOG、Lancet Reg Health West Pac等期刊。Tel:025-86868471,E-mail:yuanlin@njmu.edu.cn。
