试管婴儿双胎的母儿围生期情况

Characteristics of maternal and in-vitro fertilization twins in the perinatal period

目的：探讨试管妊娠双胎与自然妊娠双胎母儿一般临床特征及试管妊娠双胎对母儿的影响。方法选取2010年1月—2015年1月在北京某医院分娩的172对试管妊娠双胎（试管妊娠组）和476对自然妊娠双胎（自然妊娠组）。比较两组母亲生育时年龄、妊娠时间、分娩方式、妊娠期合并症及两组新生儿的情况。结果试管妊娠组母亲生育时平均年龄高于自然妊娠组，平均妊娠时间低于自然妊娠组，母亲为高龄产妇、剖宫产、先兆流产史、胎盘前置、妊娠合并甲状腺功能减低的发生率均高于自然妊娠组，差异均有统计学意义。试管妊娠组新生儿双胎体质量差异率≥25％的比率（7.0％）高于自然妊娠组（2.9％），差异有统计学意义（P ＜0.05）。结论应加强试管双胎妊娠孕妇的产前检查和胎儿的监护，预防妊娠并发症，防止母婴不良结局。

Objective This study aims to evaluate the pregnancy outcomes of twins after in vitro fertilization （IVF-ET）and to compare with those of the natural twins. Methods 172 pairs of twins after IVF-ET and 476 pairs of natural pregnancy twins were selected as the study subjects in a hospital in Beijing.Data on maternal age,length of gestation, delivery mode,pregnancy complications,and neonate health were retrospectively analyzed,and were compared between the two groups. Results The average maternal age in the IVF-ET group was older and the gestational length was shorter （P 〈0.05）in the IVF-ET group than in the natural pregnancy group.The proportions of elderly parturient women, cesarean delivery,history of threatened abortion,placenta previa,and pregnancy with hypothyroidism in the IVF-ET group were higher than those of the natural pregnancy group （Ps 〈0.05）.The ratio of the discordance rate over than 25% in the IVF-ET group was 7.0%,higher than that of the natural pregnancy group （P 〈0.05）. Conclusion Postoperative IVF-ET twins in pregnant women and fetal monitoring should be strengthened,so as to prevent pregnancy complications and maternal and neonatal undesirable outcomes.