辅助生殖技术单胎妊娠女性围产结局分析

Analysis of perinatal outcomes in assisted reproductive technology singletons

目的:分析辅助生殖技术(ART)单胎妊娠女性围产期母婴结局与自然妊娠女性的差异。方法:回顾性分析了234例ART单胎妊娠女性(ART组)和20 906名自然妊娠单胎女性(自然妊娠组)围产期妊娠结局,分别比较两组间母婴围产期并发症差异,包括妊娠期高血压疾病、妊娠期糖尿病(GDM)、前置胎盘、早产、产后出血、分娩方式等,新生儿结局如新生儿平均出生体重、新生儿窒息、低出生体重儿及巨大儿的发生率、新生儿转入新生儿重症监护病房(NICU)的发生率及新生儿出生性别比。结果:ART组较自然妊娠组GDM(χ^2=67.978,P=0.000)、前置胎盘(χ^2=27.565,P=0.000)、早产(χ^2=11.874,P=0.001)、剖宫产分娩(χ^2=92.042,P=0.000)的发生风险均显著增加。ART组较自然妊娠组低出生体重儿(χ^2=13.534,P=0.000)、巨大儿(χ^2=8.328,P=0.004)、新生儿转入NICU(χ^2=5.763,P=0.016)的发生风险均显著增加。结论:与自然妊娠女性相比,ART单胎妊娠女性母婴不良围产结局显著增加。

Objective: To analyze the perinatal outcomes of assisted reproductive technology(ART)singleton pregnancies in comparison to spontaneously conceived singletons. Methods: Perinatal outcomes of 234 ART singletons(ART group) and 20 906 spontaneous pregnancies(spontaneous pregnancy group)were analyzed retrospectively. Perinatal complications such as hypertensive disorders complicating pregnancy(HDCP),gestational diabetes mellitus(GDM),placenta previa,premature delivery,postpartum hemorrhage,mode of delivery and neonatal outcomes such as neonatal average birth weight, the incidence of the neonatal asphyxia,low birth weight infants,macrosomia,and neonatal transfer to NICU and neonatal sex ratio were compared between the two groups. Results: ART group had higher GDM(χ^2= 67.978, P=0.000),placenta previa(χ^2=27.565, P=0.000), premature delivery(χ^2=11.874, P=0.001)and cesarean delivery rate(χ^2=92.042, P=0.000)than spontaneous pregnancy group. ART group had higher low birth weight infants(χ^2=13.534, P=0.000),macrosomia(χ^2= 8. 328, P = 0. 004) and neonatal transfer to NICU rate(χ^2= 5. 763, P = 0. 016) than spontaneous pregnancy group.Conclusion: Compared with spontaneous pregnancy group, ART singleton pregnancies increased the risks of adverse perinatal outcomes.