试管婴儿新生儿期并发症及出生缺陷分析

Neonatal complications and birth defects in infants conceived by in vitro fertilization

目的了解试管婴儿的生存质量,并探讨导致试管婴儿出生缺陷及新生儿期并发症的影响因素。方法比较150例采用体外受精(IVF)技术受孕的婴儿(IVF组)与200例自然受孕婴儿(对照组)的出生情况、母亲妊娠期疾病、出生缺陷及新生儿期并发症等指标;通过非条件logistic回归分析对试管婴儿出生缺陷及新生儿期并发症的影响因素进行分析。结果与对照组比较,IVF组双胎及低出生体重儿构成比增高(P<0.01),而出生体重降低(P<0.05)。与对照组母亲相比,IVF组母亲生产年龄偏大,剖宫产、胎膜早破及妊娠合并症发生率增高(P<0.05)。IVF组出生缺陷发生率与对照组比较差异无统计学意义(P>0.05)。与对照组相比,IVF组低出生体重及硬肿症发生率增高(P<0.05),住院时间更长(P<0.01)。非条件logistic回归分析显示IVF、早产、双胎及母亲妊娠合并症是导致低出生体重的危险因素(P<0.05)。结论 IVF婴儿出生缺陷发生率与自然受孕儿无明显差异,但双胎构成比、低出生体重发生率高于自然受孕儿,住院时间更长;自然受孕、避免早产、减少双胎妊娠及预防母亲妊娠合并症可降低低出生体重的发生率。

Objective To investigate the survival quality of infants conceived by in vitro fertilization（IVF） and to identify the factors that cause birth defects and neonatal complications in IVF infants. Methods The study included 150 IVF infants（IVF group） and 200 naturally conceived infants（control group）. Indicators such as birth situation, gestational disease, birth defects, and neonatal complications were compared between groups. The influencing factors for birth defects and neonatal complications were analyzed by non-conditional logistic regression analysis. Results Compared with the control group, the IVF group had increased incidences of twin pregnancy and low birth weight（P〈0.01） but decreased average birth weight（P〈0.05）. In the IVF group, the mother＇s age was elder, with higher incidence of cesarean section, premature rupture of membranes, and pregnancy complications, as compared with the control group（P〈0.05）. There was no significant difference in the incidence of birth defects between the two groups（P〈0.05）. The IVF group had higher incidence rates of low birth weight and neonatal scleroderma（P〈0.05）, with a longer hospital stay（P〈0.01）, as compared with the control group. The non-conditional logistic regression analysis indicated that IVF, prematurity, twin pregnancy, and pregnancy complications were risk factors for low birth weight（P〈0.05）. Conclusions There is no significant difference in the incidence of birth defects between IVF and naturally conceived infants. However, IVF infants have higher incidences of twin pregnancy and low birth weight, with a longer hospital stay, as compared with naturally conceived infants. Natural conceiving, avoiding prematurity, twin pregnancy, and pregnancy complications will reduce the incidence of low birth weight.