Analysis of Factors Influencing the Cumulative Pregnancy Outcome of In Vitro Fertilization-Embryo Transfer in Women Aged 35 Years and Older with Normal Ovarian Reserve

Background:To investigate the factors associating with the cumulative clinical pregnancy outcome of in vitro fertilization-embryo transfer(IVF-ET)in women aged 35 years and older with normal ovarian reserve.Methods:A total of 358 patients undergoing IVF-ET at the Department of Reproductive Medicine,the First Affiliated Hospital of Xinjiang Medical University between January 2014 and June 2016 were analyzed by the Kaplan-Meier method and Cox proportional hazards model.Results:The probability of pregnancy in women 35-37 years of age and 38-40 years of age was 75.9%(95%confidence interval[CI]:75.1%-76.7%)and 66.9%(95%CI:65.6%-68.2%),respectively,and it was 37.8%(95%CI:34.7%-41.1%)in women aged 40 years and older.Univariate analysis(hazard ratio[HR]:2.50,95%CI:1.647-3.774)and multivariate analysis(HR:2.17,95%CI:1.427-3.268)showed a correlation between the number of retrieved oocytes and successful pregnancy.Conclusions:The number of retrieved oocytes plays a key role in the pregnancy outcome of women aged 35 years and older with normal ovarian reserve.We recommend the number of retrieved oocytes be increased for women aged 35 years and older with normal ovarian reserve.

高龄经产妇的妊娠结局分析及护理对策探讨

目的分析高龄经产妇的病例特点和妊娠结局,探讨临床护理对策,为高龄经产妇妊娠管理提供指导依据。方法回顾性分析2016年1月—12月在北京大学第三医院产科分娩的所有经产妇临床资料,共1 469例,产妇年龄在22～54岁,平均年龄(34.3±3.4)岁,平均分娩年龄大于35岁。根据产妇年龄分成三组,分娩时年龄<35岁为非高龄组,共769例;年龄在35≤～<40岁之间的为高龄组,共608例;年龄≥40岁为超高龄组,共92例。比较三组产妇的妊娠期合并症及并发症、剖宫产率及围产儿结局情况。结果三组经产妇妊娠期糖尿病、产后出血、子宫肌瘤、瘢痕子宫及剖宫产的发生率随年龄增加而增长,组间差异均有统计学意义。三组经产妇妊娠期高血压疾病、胎膜早破、前置胎盘的发生率比较,差异均无统计学意义。三组围产儿的早产、巨大儿、新生儿窒息及死胎的发生率比较,差异均无统计学意义。结论高龄经产妇妊娠期糖尿病、产后出血、子宫肌瘤、瘢痕子宫及剖宫产的发生风险随年龄增加而增长,应加强高龄经产妇的孕前及孕期教育,加强孕期管理,保障母婴健康。

“全面二胎”政策下≥35岁女性二胎生育意愿及影响因素分析

目的探索“全面二胎”政策下≥35岁女性二胎生育意愿及影响因素。方法基于2015年中国综合社会调查(CGSS)数据库,根据研究目的选取样本1674人,使用描述性统计分析、χ2检验、二元logistic回归进行分析。结果1674名年龄≥35岁女性中,有二胎生育意愿的占78.43%。二元logistic回归分析结果显示,学历、生活幸福感、拥有房产数量、生育男孩数量、未成年子女数量、婚姻状况是年龄≥35岁女性二胎生育意愿的影响因素(P<0.05)。具有初中(OR=0.392)、高中/中专(OR=0.385)、大专(OR=0.236)、本科学历(OR=0.301)、丧偶(OR=0.079)的≥35岁女性二胎生育意愿较低;生活比较幸福(OR=3.741)、再婚有配偶(OR=3.041)的≥35岁女性二胎生育意愿较高;拥有房产数量(OR=1.547)、生育男孩数量(OR=1.700)、未成年子女数量(OR=1.465)多的≥35岁女性二胎生育意愿更强烈。结论提高经济收入、稳定房价、增加产假时长、鼓励父亲参与抚养有利于提高≥35岁女性二胎生育意愿,做好优生优育工作及提升妇幼保健能力同样不容忽视。