Situations d’assistance médicale à la procréation en pédopsychiatrie : une clinique particulière ?

Abstract

BackgroundIn daily practice, the clinical impression suggests an over-representation of children from medically assisted procreation (MAP) in the population consulting in child psychiatry. This raises the question of the reality of this over-representation and the impact of the MAP on the psychic child's development. Based on the different reflections that have been carried out in the case of adoption, the study presented here attempts to provide a reflection on the current state of families and how the MAP comes to upset our representations. MethodsThis is a non-interventional descriptive cross-sectional study including a population of 262 families whose children are followed at the Alfred Binet Center, a child psychiatry consulting center in Paris. The main outcome measure is the over-representation of children from MAP in the Alfred Binet Center active queue. The secondary judgment criteria is: whether or not the consulting physicians know the MAP birth status of their patients. This criterion was measured by evaluating a difference between the two methods of collecting information (consulting physicians vs questionnaires) as well as by describing the population of children from Alfred Binet Center MAP, by comparing it to the population of children of ordinary conception. ResultsChildren from MPA were significantly more represented in the Alfred Binet Center population between 1997 and 2015 (p<0.05) and between 2006 and 2015 (p<0.0001). There are other significant differences between MAP patients and naturally conceived children with a higher rate of prematurity respectively (43.7% vs 3.7%), a younger average age (4.8 years vs 9.76 years) and an over-representation of single-parent families (25% vs 6.1%). The results of this study are important but have certain limitations. Firstly, it is a unicentric study. Secondly, the cofactors identified are insufficient to explain the real impact of the MPA on the child's psychic development. ConclusionThere is an overrepresentation of children from MAP in the population of the Alfred Binet Center. However, these results do not explain a specific psychic development. Additional multicentric, quantitative and qualitative studies are necessary to support these results. In this perspective, research is underway at the Alfred Binet Center on the development and the future of children born from MAP.