Following community concerns regarding the status of children conceived by in vitro fertilization (IVF), 33 children who had received pediatric follow-up were seen for a psychosocial evaluation. Parents were interviewed in a semistructured format by a child psychiatrist regarding their child's development, child-centered problems, parental problems, marital issues, parenting experience, and experience of the IVF program. The Bayley Scales of Infant Development were administered to the children by a clinical psychologist. Children's ages ranged from 12 to 37 months (the majority between 12 and 20 months). There was a high incidence of prematurity and twins in the population seen. Twenty-two children had no current problems and seven presented minor problems. Of the four with significant developmental problems, two had been very low-birth weight infants with significant neurological problems and one had severe congenital heart disease. Overall Bayley Scale scores were within the normal range and parents as a group were seen to function well. Problems presented were in accordance with those expected in a population of this age range, particularly considering the high incidence of prematurity.
Objective. To determine the growth and physical outcome at 2 years of age for children born after assisted reproductive techniques in the state of Victoria.
Design. Using a case-matched control study between January 1991 and July 1993, 314 children (196 singletons, 47 sets of twins, 8 sets of triplets) conceived after in vitro fertilization (IVF) and related techniques at the Monash IVF and Royal Women's Hospital Reproductive Biology Unit and 150 control children (113 singletons, 17 sets of twins, 1 set of triplets) randomly selected from the general population using the Victorian Perinatal Data Collection Unit records were enrolled to be examined for minor dysmorphic and major organ abnormalities. Singleton and twin cases were matched for plurality and gestation and date of birth. Triplets were not matched.
Results. IVF status was not a significant independent factor for physical outcomes, including malformation rates, nor for days of hospitalization postdischarge and operations. There was no significant interaction between IVF status and mean percentiles for weight and head circumference. The IVF group had a greater mean length percentile. Twins in both groups had significantly poorer physical outcomes than singletons on some measures.
Conclusion. This study did not demonstrate an independent IVF effect on the growth and physical outcome of children at 2 years of age when matched for plurality and gestation. The poor outcomes where noted were related to the effects of multiple births. These findings must be viewed in context of the response rates and therefore representativeness of the data. The need for longitudinal studies is demonstrated.
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