摘要
目的探讨人工辅助生殖技术(assisted reproductive technology,ART)及自然受孕孪生早产儿临床结局。方法收集医院2015-01至2020-12出生的孪生早产儿,共计364例(182对),根据受孕方式不同分为ART组和自然受孕组,ART组孪生156例(78对),自然受孕组孪生208例(104对)。对两组孪生早产新生儿期并发症情况进行回顾性分析,收集母孕期一般情况、并发症、孪生早产儿出生时孕周、Apgar评分、孪生体重及体重差值、出生后合并呼吸窘迫综合征(respiratory distress syndrome,RDS)、新生儿宫内感染性肺炎、新生儿低血糖症、院内感染、应用呼吸支持情况、应用中心静脉置管(PICC和(或)UVC)、Ⅲ~Ⅳ度颅内出血、动脉导管未闭(≥3.0 mm)、支气管肺发育不良(bronchopulmonary dysplasia,BPD)、早产儿视网膜病变(retinopathy of prematurity,ROP)、住院天数、应用静脉营养时间等信息,比较两组之间的差异。结果ART组产妇年龄大于35岁为26.3%,高于自然受孕组(14.9%),ART组产妇孕期合并糖尿病、高血压、甲状腺功能减低症比例均高于自然受孕组,差异有统计学意义(P<0.05)。ART组早产儿出生发生重度窒息、合并新生儿呼吸窘迫综合征、宫内感染性肺炎的发生率、应用中心静脉置管[包括PICC和(或)UVC,χ^(2)=4.015]和静脉营养的时间(t=5.626)均高于或长于自然受孕组,差异均有统计学意义(P<0.05)。结论ART双胎早产儿易发生重度窒息、新生儿呼吸窘迫综合征和宫内感染性肺炎,需加强孪生早产新生儿围生期保健及管理,避免不良结局。
Objective To investigate the artificial assisted reproductive technology(assisted reproductive technology,ART)and the clinical outcome of premature twins born naturally.Methods A total of 364 premature twins(182 pairs)hospitalized in pediatrics from January 2015 to December 2020 were collected,and divided into ART group(78 pairs)and natural pregnancy group(104 pairs)according to different pregnancy methods.The neonatal complications of twin preterm birth in the two groups were analyzed retrospectively.The general conditions of mother pregnancy,complications,gestational weeks of twin preterm birth,Apgar score,twin weight and weight difference,postnatal respiratory distress syndrome,neonatal intrauterine infectious pneumonia,neonatal hypoglycemia,nosocomial infection,application of respiratory support,application of Central venous catheterization(PICC and/or UVC),gradeⅢ~Ⅳintracranial hemorrhage,patent ductus arteriosus(≥3.0 mm),bronchopulmonary dysplasia(BPD),retinopathy of prematurity(ROP),length of hospital stay and time of intravenous nutrition were compared between the two groups.Results The maternal age of more than 35 years in the ART group(19.7%)was higher than that in the natural pregnancy group(14.2%).Gestational diabetes,hypertension and hypothyroidism in the ART group were higher than those in the natural pregnancy group,and the difference was statistically significant(P<0.05).The incidence of severe asphyxia and neonatal intrauterine infectious pneumonia in the ART group were higher than those in natural pregnancy group(χ^(2)=5.317),and the incidence of BPD and central venous catheterization(including PICC and/or UVC,χ^(2)=8.144)and the time of intravenous nutrition(t=2.073,P<0.05)were higher than those in natural pregnancy group(P<0.05).Conclusions Premature twin infants with ART are prone to severe asphyxia,neonatal respiratory distress syndrome and intrauterine infectious pneumonia.Perinatal care and management of premature twin infants should be strengthened to avoid adverse outcomes.
作者
郭玉婷
张雪峰
GUO Yuting;ZHANG Xuefeng(Department of Paediatrics,the Fifth Medical Center of Chinese PLA General Hospital,Beijing 100049,China)
出处
《武警医学》
CAS
2022年第9期764-768,共5页
Medical Journal of the Chinese People's Armed Police Force
关键词
双胎
并发症
早产儿
辅助生殖技术
新生儿
twins
complication
premature infant
assisted reproductive technology
the newborn
