上海2004—2015年辅助生殖技术婴儿不良出生结局分析

Adverse birth outcomes among puerperants receiving assisted reproductive techniques in Shanghai,2004-2015

目的探索辅助生殖技术(ART)妊娠分娩的新生儿不良出生结局发生情况及影响因素。方法采用数据库匹配方法,识别2004—2015年上海市出生监测数据库中ART婴儿5 858例,描述其出生特征,分析ART婴儿各种不良出生结局发生情况,并应用Poisson回归模型测算其相对危险度。结果 ART婴儿双多胎比例为35.73%,高于总体2.12%的水平。ART单胎婴儿早产、低体重和出生缺陷的发生风险均有所增高,发生率分别为8.34%、4.75%和1.65%,校正RR值分别为1.70(95%CI=1.52~1.90),1.68(95%CI=1.45~1.95)和1.66(95%CI=1.29~2.13)。ART双多胎婴儿早产、低体重和出生缺陷发生率分别为58.39%、44.19%和1.72%,与总体差异无统计学意义。结论 ART技术助孕后多胎率明显升高,ART新生儿早产、低体重和出生缺陷的风险也有所增高。

Objective To explore the incidence of adverse birth outcomes and its influencing factors among puerperants receiving assisted reproductive techniques （ART）. Methods Using data linkage method, information on 5 858 neonates born to mothers conceiving ART between 2004 through 2015 were collected from datasets of birth registry in Shanghai municipality. Birth characteristics and incidents of adverse birth outcomes among the neonates were described and Poisson regression model was adopted to analyze relative risk of the adverse birth outcomes. Results The proportion of multiple birth among the neonates was 35.73%, which was much higher than that （2.12%） among all the newborns during the period. The incidences of preterm birth, low birth weight and birth defect among the singleton neonates born to mothers receiving ART were 8.34%, 4.75% and 1.65%, respectively; increased risk of preterm birth, low birth weight, and birth defects were observed in the singleton neonates, with the adjusted relative risks （RRs） of 1.70 （95% confidence interval[95% CI]：1.52-1.90）,1.68 （95% CI：1.45-1.95）, and 1.66 （95% CI：1.29-2.13）. The incidences of preterm birth, low birth weight, and birth defects were 58.39%, 44.19%, and 1.72% among the neonates of multiple birth, which were not higher than those among the all multiple birth neonates during the period. Conclusion The incidence of multiple birth increases obviously and the incidences of preterm birth, low birth weight, and birth defect also raise among the neonates born to mothers receiving assisted reproductive techniques.