辅助生殖技术受孕对妊娠结局影响的回顾性队列研究

A Retrospective Cohort Study on the Effects of Assisted Reproductive Technology Conception on Pregnancy Outcomes

目的探讨辅助生殖技术(ART)受孕对妊娠结局的影响。方法选择2018年1-12月在南通市妇幼保健院分娩的514例孕产妇资料进行回顾性队列研究,其中通过ART受孕并分娩的247例为辅助组,按1:5随机抽取同期自然受孕的267例为自然组,比较两组孕产妇的一般资料及围产结局。结果辅助组孕妇的平均怀孕年龄为30.13岁、孕早期BMI 22.53 kg/m2、PCOS患病率7.69%,分别高于自然组的28.2岁、21.71 kg/m2、1.12%,差异有统计学意义(t=5.480、2.732,P<0.01;χ^2=11.957, P<0.01);辅助组孕妇的妊娠糖尿病、妊娠期高血压、妊娠期胆汁淤积症、胎盘粘连、产后出血的发生率依次为27.53%、14.98%、10.12%、19.43%、12.55%,分别高于自然组的15.36%、5.62%、1.87%、12.73%、2.62%,差异有统计学意义(χ^2=11.381、12.366、15.881、4.294、18.475,P<0.05);辅助组双胎发生率为35.22%、剖宫产率78.95%、新生儿早产率35.63%、低出生体重儿率24.85%、转NICU率13.47%,分别高于自然组2.62%、43.45%、15.33%、9.49%、8.03%,差异有统计学意义(χ^2=91.255、67.670、31.862、24.139、4.549,P <0.05)。结论通过辅助生殖技术受孕的妇女更易发生产科并发症,并会增加双胎、早产、低体重儿和剖宫产的发生风险。

Objective To investigate the effect of assisted reproduction technology(ART) conception on pregnancy outcome. Methods A retrospective cohort study was performed on the data of 514 pregnant women who delivered at Nantong Maternal and Child Health Hospital from January to December 2018. Among them, 247 cases who were conceived and delivered by ART were used as the auxiliary group, according to 1: 5 randomly selected 267 cases of natural pregnancy during the same period as the natural group, and compared the general information and perinatal outcome of the two groups of pregnant women. Results The average pregnancy age of the pregnant women in the auxiliary group was 30.1 years, the prevalence of BMI 22.53 kg/m^2, and the prevalence of PCOS were 7.69%, which were higher than the natural group’s 28.2 years old, 21.71 kg/m^2, and 1.12%, respectively. The differences were statistically significant(t=5.480, 2.732, P<0.01;χ^2=11.957, P<0.01);the incidence of gestational diabetes, gestational hypertension, cholestasis during pregnancy, placental adhesion, and postpartum hemorrhage in the auxiliary group was27.53%, 14.98%, 10.12%, 19.43%, and 12.55%, which are respectively higher than the natural group’s 15.36%,5.62%, 1.87%, 12.73%, and 2.62%, and the difference was statistically significant(χ^2=11.381、12.366、15.881、4.294、18.475,P<0.05);the incidence of twins in the auxiliary group was 35.22%, the rate of cesarean section was 78.95%, the rate of preterm birth was 35.63%, the rate of low birth weight infants was 24.85%, and the rate of transfer to NICU was13.47%, respectively, higher than the natural group 2.62%, 43.45%, 15.33%, 9.49%, 8.03%, the difference was statistically significant(χ^2=91.255, 67.670, 31.862, 24.139, 4.549, P<0.05). Conclusion Women conceived with assisted reproductive technology are more likely to have obstetric complications and increase the risk of twins, preterm birth,low birth weight, and cesarean section.