辅助生殖双胎与自然妊娠双胎的临床分析

A clinical analysis of outcomes of twin pregnancy conceived by ART and natural twin pregnancy

目的探讨辅助生殖双胎与自然妊娠双胎的临床结局。方法对照分析陕西省妇幼保健院2007年50例辅助生殖双胎(辅助生殖组)与113例自然妊娠双胎(自然妊娠组)孕产妇的年龄、孕产次、孕周、剖宫分娩与自然分娩、双胎妊娠并发症、新生儿体重、新生儿评分、窒息、死亡及畸形、双胎体重不协调状态、孕产妇并发症以及脐带缠绕等临床资料,比较其妊娠结局。结果辅助生殖组与自然妊娠组在孕产妇年龄(P>0.05)、分娩方式(χ2=0.208,P>0.05)及母体合并症(P>0.05)方面比较无显著性差异,但早期早产发生率和足月分娩率辅助生殖组高于自然妊娠组,分别为6.0%、4.4%、44.0%、22.2%。新生儿结局比较,新生儿足月低体重辅助生殖技术组(31.0%)高于自然妊娠组(15.0%),χ2=6.670,P<0.05。其他无明显差异,且新生儿预后良好。结论对双胎妊娠孕妇,需加强双胎围生育期保健,以提高双胎妊娠周数,减少早产儿及低体重儿的发生。

Objective To analyse and compare clinical outcomes of twin pregnancy conceived by assisted reproductive technique （ART） and natural twin pregnancy. Methods The clinical data of 50 cases of twin pregnancy conceived by ART （ in ART twin pregnancy group） and 113 cases of natural twin pregnancy （in natural twin pregnancy group） such as age, parity, gestational weeks of the pregnant women, pattern of delivery （cesarean section or natural vaginal delivery）, complications of twin pregnancy, and neonatal weight, scores of Apgar and NBNA, neonatal asphyxia, mortality and deformities, neonatal weight incoordination, complicatlons of pregnant women and parturient women, cord entanglement and so on were analyzed and the pregnancy outcomes in the two groups were compared. Results There were no significant differences between the two groups in age of pregnant women （ P 〉 0. 05 ）, pattern of delivery （χ^2 = 0. 208, P 〉 0. 05 ） and maternal complications （ P 〉 0.05 ）. But the incidence rate of early preterm labor and rate of term labor in the ART twin pregnancy group were higher than those in the natural twin pregnancy group （6.0% vs 4.4%, 44.0% vs 22.2%, respectively）. The rate of neonatal term low birth weight in the ART twin pregnancy group was higher than that in the natural twin pregnancy group （31.0% vs 15.0% , χ^2 = 6. 670, P 〈0.05）. In other aspects there were no significant differences between the two groups and the neonatal outcomes were good. Conclusion For twin pregnant women, the perinatal health should be strengthened to prolong gestational weeks Of twin pregnancy, and reduce birth rates of premature neonate and low birth weight neonate.