体外受精-胚胎移植术后单胎妊娠早产相关因素的临床研究 |
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作者姓名: | 赵西 阿丽米热· 麦麦提 朱梦兰 谭剑平 刘玉昆 张建平 陈慧 |
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作者单位: | 1. 510120 广州,中山大学孙逸仙纪念医院妇产科2. 844000 喀什,新疆喀什地区第一人民医院妇产科 |
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基金项目: | 广东省自然科学基金项目(2018A030313162) |
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摘 要: | 目的探讨体外受精-胚胎移植术(in vitro fertilization and embryo transfer,IVF-ET)后单胎妊娠孕妇早产的相关因素及新生儿结局。 方法回顾性分析2013年8月至2015年8月在中山大学孙逸仙纪念医院分娩的250例孕产妇临床资料,其中IVF-ET后单胎妊娠早产组(A组)50例,自然妊娠单胎早产组(B组)100例,IVF-ET后单胎妊娠足月分娩组(C组)100例。记录妊娠期糖尿病、妊娠期高血压、胎膜早破、前置胎盘或低置胎盘发生率,以及新生儿结局等资料,分析IVF-ET术后单胎妊娠早产相关因素。记录和分析孕期因宫颈机能不全行宫颈环扎术操作的情况。 结果妊娠期并发症、早产儿出生体重和分娩孕周,A组和B组差异无统计学意义。妊娠期高血压(A组14%、C组3%),胎膜早破(A组42%、C组14%),前置胎盘或低置胎盘(A组12%、C组2%),新生儿出生体重A组(2225±622)g、C组(3231±482)g]、1 min Apgar评分A组(8.61±1.77)分、C组(9.49±0.94)分],5 min Apgar评分A组(9.66±0.94)分、C组(9.93±0.29)分],A组和C组比较差异均有统计学意义(P<0.05)。Logistic多因素回归分析显示妊娠期高血压、胎膜早破、前置胎盘或低置胎盘、宫颈机能不全与IVF-ET术后单胎妊娠早产相关。孕期因宫颈机能不全,需行宫颈环扎术的患者,A组为22%,B组为9%,C组为4%,A组与B、C组比较差异均有统计学意义(P均<0.05)。 结论妊娠期高血压、胎膜早破、前置或低置胎盘、宫颈机能不全是IVF-ET术后单胎妊娠早产的高危因素。IVF-ET术后单胎妊娠早产儿与足月儿相比,出生体重、1 min Apgar评分、5 min Apgar评分均较差。
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关 键 词: | 生殖技术,辅助 早产 妊娠并发症 宫颈功能不全 |
收稿时间: | 2019-05-27 |
Clinical study on related factors of premature birth of single pregnancy after in vitro fertilization and embryo transfer |
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Authors: | Xi Zhao Almiramatmat Menglan Zhu Jianping Tan Yukun Liu Jianping Zhang Hui Chen |
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Affiliation: | 1. 510120 Guangzhou, Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital2. 844000 Kashgar, Department of Obstetrics and Gynecology, First People′s Hospital, Kashgar, Xinjiang |
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Abstract: | ObjectiveTo investigate the related factors of preterm birth and neonatal outcomes in single pregnancy after in vitro fertilization and embryo transfer (IVF-ET). MethodA retrospective analysis was conducted in 250 pregnant women in the Sun Yat-sen Memorial Hospital from August 2013 to August 2015. The patients were divided into preterm birth of single pregnancy after IVF-ET (group A, 50 cases), preterm birth of single pregnancy after natural pregnancy (group B, 100 cases) and full-term birth of single pregnancy after IVF-ET (group C, 100 cases). By recording the incidence of gestational diabetes mellitus, gestational hypertension, premature rupture of membranes, placenta praevia or low-positioned placenta, as well as neonatal outcome, analyze the factors related to preterm delivery of single pregnancy after IVF-ET. ResultsThere were no significant differences in pregnancy complications, birth weight of premature infants and gestational weeks between group A and group B. The incidences of gestational hypertension in group A and group C were (14% and 3%), premature rupture of membranes (42% and 14%), placenta praevia or low-positioned placenta (12% and 2%), birth weight of newborn (2225±622) g and (3231±482) g], 1 min Apgar score (8.61±1.77) and (9.49±0.94)], 5 min Apgar score (9.66±0.94) and (9.93±0.29)], and the differences between the two groups were statistically significant (P<0.05). Logistic regression analysis showed that gestational hypertension, premature rupture of membranes, placenta praevia or low-positioned placenta, cervical incompetence were associated with preterm birth of single pregnancy after IVF-ET. The incidences of cervical cerclage in pregnancies due to cervical incompetence were 22%, 9% and 4% in group A, group B and group C, respectively. There were significant difference between group A and group B, group C (P<0.05), respectively. ConclusionsGestational hypertension, premature rupture of membranes, placenta praevia or low-positioned placenta and cervical incompetence are high risk factors for preterm birth of single pregnancy after IVF-ET. The birth weight, Apgar score at 1 min and 5 min were all worse in preterm infants than in full term infants of single pregnancy after IVF-ET. |
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Keywords: | Reproductive techniques assisted Premature birth Pregnancy complications Uterine cervical incompetence |
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