RESUMO
Introducción. En los últimos años algunas publicaciones han demostrado una mayor incidencia de defectos congénitoso anomalías cromosómicas vinculadas a la fecundación in vitro (FIV) convencional, y otras publicaciones sugieren unaposible influencia negativa de la microinyección espermática (ICSI) sobre el neurodesarrollo. Objetivo. Determinar si habíadiferencias en el desarrollo médico y en el neurodesarrollo entre niños concebidos por técnicas de FIV convencional y niñosconcebidos por técnicas de ICSI. Sujetos y métodos. La muestra se compone de 17 infantes nacidos por FIV (nueve niños yocho niñas) y de 40 infantes nacidos por ICSI (23 niños y 17 niñas). Todos ellos procedían de embarazos de FIV y de ICSI obtenidosen el servicio de reproducción asistida de nuestro hospital y controlados por el mismo equipo de obstetricia y perinatología.A todos los pacientes se les realizó una exploración pediátrica a los 24 meses de edad cronológica y una exploraciónneuropsicológica. La exploración se realizó en una única sesión. Se evaluó específicamente el neurodesarrollo mediante lasescalas de Bayley de desarrollo infantil. Resultados y conclusiones. Los infantes de FIV convencional y e ICSI de nuestro estudiomostraron una salud y un neurodesarrollo similares a los de la población general a la edad de 2 años. La ICSI, comparadacon la FIV convencional, se muestra tan segura como ésta en relación con la evolución médica y cognitiva de los niños (AU)
Introduction. In recent years a number of publications have reported a higher incidence of congenital defects or chromosome abnormalities linked to conventional in vitro fertilisation (IVF), and some other publications have suggested that intracytoplasmic sperm injection (ICSI) may have a negative influence on neurodevelopment. Aim. To determine whether there were any differences in the medical development and the neurodevelopment of children conceived using conventionalIVF techniques and those conceived using ICSI techniques. Subjects and methods. Our sample consisted of 17 babies born after IVF (nine males and eight females) and 40 infants born after ICSI (23 males and 17 females). All of them were the resultof pregnancies induced by IVF and ICSI achieved in the assisted reproduction service at our hospital and followed up by the same team of obstetricians and specialists in maternal-foetal medicine. At the chronological age of 24 months all the patients were submitted to a paediatric examination and a neuropsychological examination. The examination was performed in onesingle session. Neurodevelopment was evaluated specifically by means of the Bayley scales of infant development. Results and conclusions. The health and neurodevelopment of infants from conventional IVF and from ICSI in our study were similar to those of the general population at the age of two years. ICSI proved to be as safe as conventional IVF as regards the childrens medical and cognitive progression (AU)
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Fertilização In Vitro/instrumentação , Fertilização In Vitro/psicologia , Fertilização In Vitro/estatística & dados numéricos , Desenvolvimento Embrionário e Fetal/fisiologia , Crescimento e Desenvolvimento/genética , Gravidez/fisiologia , Gravidez/estatística & dados numéricos , Infertilidade/diagnóstico , Infertilidade/epidemiologia , Infertilidade/terapiaRESUMO
INTRODUCTION: In recent years a number of publications have reported a higher incidence of congenital defects or chromosome abnormalities linked to conventional in vitro fertilisation (IVF), and some other publications have suggested that intracytoplasmic sperm injection (ICSI) may have a negative influence on neurodevelopment. AIM. To determine whether there were any differences in the medical development and the neurodevelopment of children conceived using conventional IVF techniques and those conceived using ICSI techniques. SUBJECTS AND METHODS: Our sample consisted of 17 babies born after IVF (nine males and eight females) and 40 infants born after ICSI (23 males and 17 females). All of them were the result of pregnancies induced by IVF and ICSI achieved in the assisted reproduction service at our hospital and followed up by the same team of obstetricians and specialists in maternal-foetal medicine. At the chronological age of 24 months all the patients were submitted to a paediatric examination and a neuropsychological examination. The examination was performed in one single session. Neurodevelopment was evaluated specifically by means of the Bayley scales of infant development. RESULTS AND CONCLUSIONS: The health and neurodevelopment of infants from conventional IVF and from ICSI in our study were similar to those of the general population at the age of two years. ICSI proved to be as safe as conventional IVF as regards the children's medical and cognitive progression.
Assuntos
Desenvolvimento Infantil , Anormalidades Congênitas/etiologia , Sistema Nervoso , Técnicas de Reprodução Assistida , Injeções de Esperma Intracitoplásmicas , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Sistema Nervoso/embriologia , Sistema Nervoso/crescimento & desenvolvimento , Testes Neuropsicológicos , Avaliação de Resultados em Cuidados de Saúde , Gravidez , Desempenho Psicomotor , Técnicas de Reprodução Assistida/efeitos adversos , Injeções de Esperma Intracitoplásmicas/efeitos adversos , Injeções de Esperma Intracitoplásmicas/métodosRESUMO
Attention deficit hyperactivity disorder (ADHD) is a developmental disorder characterized by inattentiveness, motor hyperactivity and impulsivity. According to neuroimaging data, the neural substrate underlying ADHD seems to involve fronto-striatal circuits and the cerebellum. However, there are important discrepancies between various studies, probably due to the use of different techniques. The aim of this study is to examine cerebral gray (GM) and white (WM) matter abnormalities in a group of ADHD children using a voxel-based morphometry protocol. The sample consisted of 25 children/adolescents with DSM-IV TR diagnosis of ADHD (medicated, aged 6-16 years) who were compared with 25 healthy volunteer children/adolescents. ADHD brains on an average showed a global volume decrease of 5.4% as compared to controls. Additionally, there were regionally specific effects in the left fronto-parietal areas (left motor, premotor and somatosensory cortex), left cingulate cortex (anterior/middle/posterior cingulate), parietal lobe (precuneus bilaterally), temporal cortices (right middle temporal gyrus, left parahippocampal gyrus), and the cerebellum (bilateral posterior). There were no differences in WM volume between ADHD children and control subjects. The results are consistent with previous studies that used different techniques, and may represent a possible neural basis for some of the motor and attentional deficits commonly found in ADHD.