辅助生殖技术单胎活产儿出生缺陷率分析

The Analysis of Birth Defects Rate Among Single Live-birth Infants after Assisted Reproductive Technology

目的 :观察不同辅助生殖技术(ART)单胎活产儿出生缺陷发生的情况,探讨ART单胎活产儿出生缺陷的相关影响因素,为降低ART出生缺陷率提供依据。方法 :选取2016年1月～2016年12月在长沙市中信湘雅生殖与遗传专科医院行ART治疗并获得单胎活产的周期,出生缺陷分类根据疾病和有关健康问题的国际统计分类第10次修订本(ICD-10)中Q00～Q99先天畸形、变性和染色体异常方法分类,采取回顾性分析的方法,对不同助孕方式的子代出生缺陷率进行比较,同时分析多种因素对ART新生儿出生缺陷率的影响。结果 :共纳入研究10567例患者资料,其中新鲜胚胎移植组(f ET)6381例,包括体外受精-胚胎移植(ⅣF-ET)组4795例,卵胞浆内单精子注射(ICSI)组1586例;冻融胚胎移植组(FET)4186例。共218例ART出生缺陷儿,出生缺陷率为2.06%。f ET组共127例出生缺陷儿,出生缺陷率为1.99%,FET组出生缺陷儿91例,出生缺陷率为2.17%,两组差异无统计学意义;ⅣF组出生缺陷儿102例,出生缺陷率为2.13%;ICSI组出生缺陷儿25例,出生缺陷率为1.58%,两组差异无统计学意义。孕周<37周新生儿出生缺陷率高于孕周≥37周新生儿(孕周<37周5.87%,孕周≥37周1.77%);低出生体重新生儿出生缺陷率高于正常出生体重和巨大儿(低出生体重6.50%,正常出生体重1.84%,巨大儿1.98%)。结论 :不同ART助孕方式不会影响其单胎活产儿的出生缺陷率,早产与低出生体重可能是ART子代出生缺陷的重要影响因素。

Objective To study the birth defects rate of single live-birth infants after different assisted reproductive technologies(ART),and to explore the related influence factors of birth defects in single live-birth infants by ART.Methods 10567 single live-birth cycles in Reproductive&Genetic Hospital of Citic-Xiangya in Changsha from January 2016 to December2016 after ART were collected.Birth defects was classi?ed according to the International Classi?cation of Diseases and Health Related Problems,10 th edition(ICD-10 codes).A retrospective analysis method was used to compare the birth defects rate of the offspring,and to analyze the effects of multiply factors on the birth defects of ART neonates.Results A total of 10567 single live-birth infants were analyzed,including 4186 cases of frozen embryo transfer(FET),and 6381 cases of fresh embryo transfer(f ET)that consists of 4795 cases of in vitro fertilization-embryo transfer(ⅣF-ET)and 1586 cases of in intracytoplasmic sperm injection(ICSI).There were 218 children with birth defects and the birth defects rate was 2.06%.The rate of birth defects in fET was similar to FET(fET:1.99%,FET:2.17%).And the birth defects rate was not different betweenⅣF and ICSI(ⅣF:2.13%,ICSI:1.58%).The birth defects rate of gestational age<37 weeks group was higher than that gestational age≥37 weeks group(gestational age<37 weeks:5.87%,gestational age≥37 weeks:1.77%);The birth defects rate of low birth weight neonate was significantly higher than normal birth weight neonate and giant neonate(low birth weight neonate:6.50%,normal birth weight neonate:1.84%,giant neonate:1.98%.Conclusion Different methods of ART did not affect the birth defects rate of singleton live births.Premature and low birth weight might be important factors leading to birth defects in ART offspring.