试管婴儿(IVF-ET)新生儿期情况分析

Neonatal outcome of children born after in-vitro fertilization -embryo transfer.

目的前瞻性对体外授精-胚胎移植(IVF-ET)技术受孕出生的新生儿进行评估,探讨实施IVF-ET技术出生新生儿的安全性.方法从自2000年10月～2004年12月在本院接受IVF-ET治疗后受孕181例孕妇进行前瞻性追踪观察,将其分娩的新生儿254个作为观察组,本院产科自然妊娠分娩的新生儿1205个作为对照组,对两组单胎和总体新生儿胎龄、出生体重、Apgar评分、高胆红素血症、新生儿窒息、新生儿死亡及新生儿畸形发病率的进行观察比较.结果单胎新生儿的出生体重、Apgar评分、新生儿死亡率及新生儿畸形率与对照组无差异性(P＞0.05);单胎新生儿窒息率观察组低于对照组,两组比较有显著差异性(P＜0.05).两组总体比较新生儿畸形、新生儿窒息率、新生儿死亡率无差异性(P＞0.05),而新生儿低体重出生率、高胆红素血症、住院治疗时间,观察组明显高于对照组,两组比较有极显著差异性(P＜0.01);而Apgar评分观察组低于对照组两者比较有差异性(P＜0.05).结论 IVF-ET技术不增加新生儿畸形和围产期死亡率;多胎是IVF-ET技术主要并发症,是早产和低体重出生儿、高胆红素血症、新生儿窒息等新生儿不良结局的主要原因.

Objective： To study prospectively the neonatal outcome of children born after in vitro - fertilization embryo transfer and discuss the reliability of this technique. Methods： Choosing 254 infants from 290 IVF - ET ones from Oct. 2000 to Dec, 2004 as study group and choosing 1205 infants conceived spontaneously from obstetric register as control matched for age and parity. We separately compared the outcome of singletons and general infants in multiple births, preterm birth, gestation age, birth weight, Apgar score and pathological jaundice, neonatal death and malformation. Resalts： The survival quality of singletons of assisted reproduction are as good as that naturally conceived （ P 〉 0.05 ） ; furthermore the incidence of neonatal apnea is lower than that of control （ P 〈 0.05 ） ; there are significant difference in the inci- dence of low birth weight, pathological jaundice and the hospitalization between the two groups including maltiples （P 〈 0.01）, hut apnea, malformation and neonatal death （ P 〉 0.05）. Conclusion： The outcome of two groups singletons is approximate, but the difference were fund in comparing the outcome of two general infants for increased multiple rate and preterm delivery rate in IVF - ET infants.