父母健康與18個月人工生殖技術出生嬰兒發展之相關性-臺灣出生世代研究

背景：台灣高齡產婦人數上升，婦女生育率下降，人工生殖出生嬰兒有增加的趨勢。此族群多胞胎妊娠機率高，提升新生兒早產風險，或是較差的出生狀況。目的：探討父母健康與18個月人工生殖技術出生嬰兒發展之相關性。方法：本研究利用2007年臺灣出生世代研究(Taiwan Birth Cohort Study; TBCS)，共有21,234名調查樣本，其中366名(1.7%)為人工生殖出生嬰兒。分析18個月人工生殖技術出生嬰兒發展之現況，探討父母人口學變項(年齡、教育程度、職業、家庭收入)、父母親自覺健康狀態問卷(SF-36)、嬰兒出生因素等，與嬰兒發展(粗動作、精細動作、語言溝通、身邊處理及社會能力)之相關性，並以SPSS 22.0套裝軟體進行描述性及推論性統計。結果：影響18個月嬰兒粗動作之相關因子為父母親職業、父親生理健康總面向、父母親心理健康總面向、週數和出生體重。精細動作之相關因子為父母親教育程度、家庭收入、父親生理健康總面向、父母親心理健康總面向、出生體重。語言溝通之相關因子為母親年齡、母親生理健康總面向、母親心理健康總面向、胎數、性別、出生體重。多元迴歸統計分析顯示父親心理健康總面向為影響嬰兒粗動作發展之預測因子。性別、出生體重、母親心理健康總面向為影響嬰兒語言溝通之預測因子。結論：父母親的心理健康對人工生殖出生18個月嬰兒的發展有影響，未來建議於產後即開始且評估父母親的心理健康，並建立長期追蹤之機制，提升父母親的心理健康，以促進嬰兒良好之發展。

Background: The fertility rate of women has decreased gradually, but births by Assisted Reproductive Technology (ART) have an increasing trend in post decades in Taiwan. This group carries a higher risk of adverse birth outcome.Objective: To explore the association between parental health and the child development of 18-month old baby born by Assisted Reproductive Technology.Methods: Using data set of the Taiwan Birth Cohort Study (TBCS) with a national sample of 21,234 births, including 366 (1.7%) born by ART in 2007. Parental demography (age, education level, occupation, family income), SF-36 Taiwan version and birth outcome, were analyzed for their associations with the development (fine motor, gross motor, language and social ability) of 18-months old baby born by ART. Descriptive and inferential statistics were done by SPSS 22.0 software.Results: The gross motors in 18-months babies born by ART were significantly associated with parental occupation, father''s PCS (physical component summary), parental MCS (mental component summary), gestational age and birth weight. The fine motor in 18-months babies born by ART were significantly associated with parental education level, family income, father''s PCS, parental MCS and birth weight. Languages in 18-months babies born by ART were significantly associated with maternal age, mother''s PCS, mother''s MCS, single or multiple births. Multipleregression analysis showed that father’s MCS was a statistically significant predictor for gross motor, while gender of babies, birth weight and mother’s MCS was a predictor of language development.Conclusion: Parental mental health was associated with the development of 18-month old baby born by ART. Health care professionals should focus and promote parental mental health to keep the development of baby born by ART.