体外受精与自然受孕后母儿围生结局的Meta分析

Maternal and neonatal perinatal outcomes in pregnancies after in vitro fertilization and natural pregnancy:a systematic:a meta analysis

目的系统评估体外受精-胚胎移植(IVF-ET)术后母亲围生期并发症和新生儿出生结局。方法计算机检索PubMed、EMbase、Cochrane图书馆、中国知网(CNKI)、万方和中国生物医学文献数据库。收集纳入了IVF和自然妊娠做对比分析的文献,采用RevMan5.3软件进行Meta分析。结果纳入了23篇符合要求的文献,共计1 312 651例,其中IVF有113 044例,自然妊娠1 199 607例。IVF母亲的年龄较自然妊娠大,孕周较自然妊娠小,后代出生体质量较自然妊娠轻(P<0.05);IVF母亲发生妊娠期高血压(PIH)、前置胎盘、产后出血以及妊娠期糖尿病(GDM)的概率较自然妊娠者高(P<0.05);IVF母亲的多胎及剖宫产率均较自然妊娠者高(P<0.05);IVF后代小于胎龄儿(SGA)、低体质量儿、死胎以及早产的发生率较自然妊娠后代高(P<0.05)。结论 IVF母亲围生期并发症较自然妊娠者高,新生儿出生结局较自然妊娠后代差。

Objective To systematically evaluate maternal perinatal complications and neonatal outcomes after in vitro fertili- zation and embryo transplantation（IVF-ET）. Methods The computer retrieval was performed on the databases of PubMed, Co- chrane library,EMbase,CNKI, Wanfang and Chinese biomedical literature＇database. The articles on the comparison between IVF and natural pregnancy were included. The RevManS. 3 software was adopted to conduct the meta analysis. Results Twenty-three articles conforming to the requirements were included,including 1 312 651 cases, among them 113 044 cases were IVF and 1 199 607 cases were natural pregnancy. IVF motherls age was larger than that of natural pregnancy, while the gestational weeks were smaller than those of natural pregnancy, the newborn birth weight was lighter than that of natural pregnancy（P〈0.05） ;the proba- bility of pregnancy-induced hypertension （PIH） ,placenta previa,postpartum hemorrhage and gestational diabetes mellitus （GDM） occurrence in IVF mother were higher than that of natural pregnancy （P〈0.05）;the rate of multiple and cesarean section in IVF mothers were higher than that of natural pregnancy （P〈0.05） ;the occurrence rates of small for gestational age（SGA） ,low birth weight infants,stillbirth and premature in IVF were higher than those of natural pregnancy （P〈：0.05）. Conclusion The maternal perinatal complications in IVF are higher than those of natural pregnancy, and the birth outcomes in IVF are worse than those of natural pregnancy.