辅助生殖技术单胎妊娠结局及低出生体重 发生情况分析

Analysis of singleton pregnancy outcome and incidence of low birth weight by assisted reproductive technology

目的探讨辅助生殖技术(ART)单胎妊娠结局及低出生体重(LBW)发生的影响因素。方法回顾性分析2016年1月至2019年12月深圳市妇幼保健管理系统中分娩活单胎的1434例患者资料,按照妊娠方式分为ART组(691例)和自然妊娠(NC)组(743例),采用单因素分析单胎孕妇妊娠结局,多因素logistic回归分析影响新生儿LBW的风险因素。结果ART组孕妇本科及以上和无既往孕产史占比高于NC组,ART组子代LBW和早产率高于NC组,差异有统计学意义(P<0.05)。单因素分析显示早产与ART子代LBW相关(P<0.01),但多因素logistic回归分析发现其不是ART子代LBW的影响因素(OR=0.816,95%CI:0.321~2.073,P=0.670)。结论ART单胎LBW发生率增加,与本研究涉及相关因素无关。但有必要加强ART孕妇高危妊娠的管理,重视孕产期保健,同时进行多地区、大样本随机对照研究明确ART助孕对单胎妊娠LBW发生的影响。

Objective To investigate the risk factors of singleton pregnancy outcome and incidence of low birth weight(LBW)with assisted reproductive technology(ART).Methods Retrospectively analyzed the clinical data of 1434 patients with live singletons in Shenzhen maternal and child health management system from January 2016 to December 2019.According to the way of pregnancy,they were divided into ART group(691 cases)and natural pregnancy(NC)group(743 cases).The univariate analysis was used to analyze the pregnancy outcome of singleton pregnant women,multivariate logistic regression analysis was performed to explore the risk factors affecting the occurrence of LBW infants.Results The proportion of pregnant women in ART group with bachelor degree or above and no previous pregnancy and childbirth history were higher than those in NC group,and the offspring′s LBW and preterm birth rate of ART group were higher than those in NC group,the differences were statistically significant(P<0.05).Univariate analysis showed that preterm birth was associated with ART offspring′s LBW(P<0.01),however,multivariate logistic regression analysis revealed that preterm birth wasn′t the influence factor of ART offspring′s LBW(OR=0.816,95%CI:0.321-2.073,P=0.670).Conclusion The incidence of ART singleton LBW increased was not related to the related factors involved in this study.However,it is not only necessary to strengthen the management of ART pregnant women with high risk and pay attention to their healthcare during pregnancy and childbirth,but also need to conduct a multi-area,large-sample randomized controlled study to clarify the impact of the occurrence of LBW in ART singletons.