摘要
目的比较不同受孕方式妊娠双胎新生儿围生期结局。方法采用回顾性队列研究方法分析2010年1月-2015年12月出生于复旦大学附属妇产科医院的1 048例不同受孕方式妊娠双胎母婴结局。其中556例为自然受孕妊娠双胎(SC组),438例为体外受精-胚胎移植妊娠双胎(IVF-ET组),54例为单纯促排卵妊娠双胎(OI组)。比较3组间产妇和新生儿的一般资料和围生期并发症发生率。结果 IVF-ET组产妇的平均年龄显著大于OI组和SC组(P值均<0.05),SC组经产妇比例显著高于OI组和IVF-ET组(P值均<0.05),3组产妇胎龄、剖宫产率、孕次和妊娠合并症发生率的差异均无统计学意义(P值均>0.05)。3组双胎儿平均出生体重的差异无统计学意义(P值均>0.05)。体重分布中,IVF-ET组低出生体重儿娩出率(37.4%)显著小于SC组(50.2%)和OI组(46.3%,P值均<0.05),3组间极低和超低出生体重儿娩出率的差异无统计学意义(P值均>0.05)。孕周分布中,IVF-ET组超早产儿娩出率(2.7%)显著高于SC组(0)和OI组(0,P值均<0.05),SC组晚期早产儿出生率显著高于OI组和IVF-ET组(P值均<0.05)。SC组单卵双胎率、双胎生长不一致、新生儿高胆红素血症、双胎输血综合征发生率均显著高于OI组和IVF-ET组(P值均<0.05)。3组间新生儿住院率、住院天数、先天畸形发生率和病死率的差异均无统计学意义(P值均>0.05)。结论辅助生殖技术受孕的双胎母婴围生期并发症与自然受孕双胎相似,结局亦无明显差异,但IVF-ET妊娠超早产儿发生率较高。
Objective To assess perinata~ outcomes of twin pregnancies through different modes of conception. Methods A total of 1 048 twin pregnancies delivered at the Obstetrics and Gynecology Hospital affiliated to Fudan University between January 2010 and December 2015 were analyzed in this retrospective cohort study. There were 556 cases of spontaneous conception （SO〉, 438 of in vitro fertilization-embryo transfer （IVF- ET） and 54 of ovulation induction （O1~. The general maternal and neonatal information and incidence of perinatal complications were compared among the three groups. Results The maternal age of twin pregnancies conceived by IVF-ET was significantly older than that of SC and OI groups （both P 〈 0. 05〉. The SC group was more frequently multiparous than OI and IVF-ET groups （both P〈0.05）. There was no significant difference among the three groups in maternal gestational age, cesarean rate, pregnant times, incidence of pregnancy complications, birth weight, or birth rate of very low or extremely low birth weight infants （all P〉0.05）. The birth rate of low birth weight infants in IVF-ET group was 37.4%, which was significantly lower than that of SC group （50.2% ） and OI group （46.3%, both P〈0.05）. Super premature delivery rate was 2.7% in the IVF-ET group, which was significantly higher than that in SO group （0） and OI group （0, both P〈0.05）. Late preterm birth rate of SC group was significantly higher than that of OI group and IVF-ET group （both P〈0.05）. The rates of monozygotic twins,inconsistent twin growth, neonatal hyperbilirubinemia and twin-twin transfusion syndrome in SC group were significantly higher than those in OI group and IVF-ET group （all P 〈0.05）. There was no significant difference in hospitalization rate, hospital stay, incidence of congenital malformation and mortality between groups （all P〉0.05）, Conclusion The perinatal complications of twin pregnancy conceived by assisted reproductive technologies are similar to those of spontaneously conceived twins, and there is no significant difference in outcome between them. However, there is a high incidence of super premature delivery in the pregnancy conceived by IVF- ET.
出处
《上海医学》
北大核心
2017年第10期598-602,共5页
Shanghai Medical Journal
基金
国家卫生和计划生育委员会公益性行业科研专项项目(201402006)
中国双胎和胎儿结构异常协作组资助
关键词
辅助生殖
体外受精-胚胎移植
双胎
双胎输血综合征
Assisted reproduction
In vitro fertilization-embryo transfer
Twins
Twin-twin transfusionsyndrome
