辅助生育技术受孕双胎与自然受孕双胎妊娠结局的分析

Perinatal outcome of twin pregnancies conceived by assisted reproductive techniques and those conceived spontaneously

目的 探讨辅助生育技术受孕 (助孕 )双胎与自然受孕双胎围产期的结局。方法 选择 10 4例助孕双胎孕妇 (助孕组 )和 173例自然受孕双胎孕妇 (自然受孕组 ) ,比较两组孕妇一般情况、妊娠合并症、分娩情况和新生儿预后等方面的差异。结果 (1)助孕组孕妇平均年龄 (31 2± 3 7)岁 ,自然受孕组孕妇为 (2 7 8± 3 5 )岁 ,两组比较 ,差异有显著性 (P <0 0 5 )。 (2 )助孕组孕妇早产 70例(6 7 3% ) ,自然受孕组孕妇早产 78例 (45 1% ) ,两组比较 ,差异有极显著性 (P <0 0 1)。助孕组孕妇患妊娠期糖尿病或糖耐量异常 16例 (15 4 % ) ,自然受孕组孕妇仅 4例 (2 3% ) ,两组比较 ,差异有极显著性 (P <0 0 1)。(3)助孕组孕妇剖宫产率为 76 0 % (79/10 4 ) ,明显高于自然受孕组的 6 5 3% (113/173)。(4)两组围产儿死亡率、畸形发生率和新生儿窒息率等比较 ,差异无显著性 (P <0 0 5 )。结论 助孕双胎孕妇年龄较大 ,早产率及妊娠期糖尿病或糖耐量异常发生率高 ;分娩方式以剖宫产为主。

Objective To investigate perinatal outcomes of twin pregnancies conceived by assisted reproductive techniques and those conceived spontaneously Methods The pregnant complications, delivery situation and neonatal outcomes of 104 twin pregnancies conceived by assisted reproductive techniques were compared to 173 spontaneous ones Results (1) The women of twin pregnancies conceived by assisted reproductive techniques were (31 2±3 7) years old,while the spontaneous ones were (27 8±3 5) years old There was significant difference between two groups ( P <0 05) (2) There were also significant differences in the incidence of premature delivery and gestational diabetes mellitus or impaired glucose tolerance( P <0 01) between two groups There were 70 cases(67 3%) premature delivery in assisted reproduction group, while 78 cases(45 1%) in spontaneous group There were 16 cases (15 4%)gestational diabetes mellitus or impaired glucose tolerance in assisted reproduction group, while 4 cases (2 3%) in spontaneous group (3) Cesarean sections were more frequently performed in assisted reproduction group (79 cases, 76 0%) than in spontaneous group(113cases,65 3%) (4)There were no statistically significant differences in perinatal deaths, congenital malformations, neonatal asphyxia between two groups( P <0 05) Conclusion The women of twin pregnancies conceived by assisted reproductive techniques were older than those conceived spontaneously The incidence of premature delivery, gestational diabetes mellitus or impaired glucose tolerance and cesarean section were higher in assisted reproduction group However, no statistically significant differences in perinatal morbidity were found between the two groups