辅助生殖技术子代生长发育情况及相关影响因素分析

发布时间：2018-06-27 16:21

本文选题：辅助生殖技术 + 自然受孕　；参考：《郑州大学》2015年硕士论文

【摘要】：第一部分辅助生殖技术子代生长发育情况及影响因素目的:通过探讨辅助生殖技术(Assisted reproductive technology,ART)子代与自然受孕(Natural conceived,NC)子代宫内生长发育情况及围生期并发症的发生情况,进而分析影响ART子代低出生体质量(Low birth weight,LBW)发生的相关影响因素。方法:选取自2012年8月-2014年8月在我院接受ART受孕并在我院住院娩出,胎龄≥28周的全部活产新生儿共287例为实验组研究对象;随机抽取同期于我院住院分娩的NC活产子代287例作为对照组。从生殖中心和产科提取所有接受辅助生殖技术治疗的病案资料,符合纳入标准的病例,用EXCEL软件建立数据库,记录孕妇的姓名、编号、年龄、学历、长期居住地、助孕方式、治疗结局、胎儿数、分娩时间、分娩孕周、分娩方式、孕产次、流产史、月经史、家族史、新生儿性别、出生体重、早孕期并发症、分娩并发症等可能的影响因素,计算机录入资料,核实数据无误后将数据导入SPSS17.0进行分析,定量资料分析采用t检验,定性资料分析采用PearsonХ2检验,检验水准α=0.05;数据服从正态性分布的用均数±标准差(x±s)表示,P0.05为差异有统计学意义。结果:1 ART组与NC组母亲年龄、学历、居住地、平素月经情况、既往生产史及先兆流产情况的比较:ART组母亲平均年龄较NC组目前年龄大、首次生产、学历偏低、居住在农村地区、平素月经不规律既及往有先兆流产史的比例较NC组高,相比差异有统计学意义。2 ART组与NC组子代出生体重、头围、身长及性别比例的比较:ART组平均头围、平均身长、平均体重均小于NC组,且差异均有统计学意义(P0.05);在子代性别比例上两组差异无统计学意义(P0.05)。3去除多胎因素后两组单胎子代的出生体重、头围、身长的比较结果:ART组单胎足月儿与单胎早产儿(胎龄无差异)的平均体重和平均身长均低于NC组,且差异有统计学意义(P0.05),但两组间单胎的头围无明显差异(P0.05)。4 ART组与NC组多胎妊娠、早产及剖宫产情况的比较:ART组多胎妊娠率(65.3%)、早产率(63.41%)和剖宫产率(90.94%)均高于NC组(分别为4.6%、24.39%、77.35%),差异均有统计学意义(P0.05);ART单胎早产的发病率(68.55%)同样高于单胎NC组(25.95%),且差异有统计学意义(P0.05)。5 ART组与NC组孕期合并症及产时合并症的比较:ART组均高于NC组,且差异均有统计学意义(P0.05)。结论:1 ART组多胎妊娠、早产、剖宫产的发生率较NC组高,去除多胎因素后ART单胎早产的发生率仍高于NC组。2 ART组子代出生体重、头围、身长明显低于NC组;去除多胎因素后,ART单胎足月儿和单胎早产儿的出生体重及身长仍低于相应的自然妊娠的单胎子代。3 ART组母亲平素月经不规律、既及往有先兆流产史、孕期合并症及产时合并症的发生率高于NC组。第二部分辅助生殖技术子代低出生体重危险因素研究目的:通过探讨辅助生殖技术(Assisted reproductive technology,ART)子代低出生体质量(Low birth weight,LBW)发生的相关危险因素,为尽可能的减少ART子代低出生体质量的发生率提供较为科学的依据。方法:选取自2012年8月至2014年8月在我院接受ART受孕并在我院住院娩出,胎≥28周的全部活产新生儿共287例为实验组研究对象;从生殖中心和产科提取所有接受辅助生殖技术治疗的病案资料,符合纳入标准的病例,用EXCEL软件建立数据库,记录孕妇的姓名、编号、年龄、学历、长期居住地、助孕方式、治疗结局、胎儿数、分娩时间、分娩孕周、分娩方式、孕产次、流产史、月经史、家族史、新生儿性别、出生体重、早孕期并发症、分娩并发症等可能的影响因素,计算机录入资料,核实数据无误后将数据导入SPSS17.0进行分析,单因素分析分析采用PearsonХ2检验,多因素采用Logistic回归分析,P0.05为差异有统计学意义。结果:1单因素分析显示:ART组孕母年龄、学历、长期居住地、产时合并症、孕期合并症、早产及多胎与子代低出生体质量有关,这些因素会不同程度的影响子代的出生体重。2多因素Logistic回归分析结果显示:多胎、产时合并胎膜早破、产时合并子痫及早产与子代低出生体质量相关:多胎,OR=3.225,95%CI=1.673~6.215,P0.001;产时合并子痫,OR=3.845,95%CI=1.607~9.201,P=0.002,;产时合并胎膜早破,OR=2.294,95%CI=1.156~4.553,P=0.018;早产,OR=11.018,95%CI=5.044~24.066,P0.001。3辅助生殖技术类型在ART子代低出生体质量的发生率上无差别。结论:1多胎、早产、产时合并子痫、胎膜早破为ART子代低出生体质量的危险因素。2辅助生殖技术类型对子代出生体重的影响无差异。
[Abstract]:The first part auxiliary reproductive technology progeny growth and development and influence factors Objective: by exploring the subgeneration of Assisted reproductive technology (ART) and natural pregnancy (Natural conceived, NC) intrauterine growth and perinatal complications, and then analyzing the influence of the low birth weight of the ART progeny. (Low birth weight, LBW) related factors. Methods: 287 cases of all live births who received ART pregnancy in our hospital in August 2012 and hospitalized in our hospital, and all live births over 28 weeks of fetal age were selected as the subjects of the experimental group; 287 cases of NC live births at the same time in our hospital were randomly selected as the control group. Center and obstetrics extract all cases of medical records receiving assisted reproductive technology, in accordance with the standard cases, using EXCEL software to establish a database to record pregnant women's name, number, age, education, long-term residence, way of pregnancy, treatment outcome, fetal number, birth time, pregnancy week, delivery mode, pregnancy, abortion history, menstrual history, family history. Family history, newborn sex, birth weight, early pregnancy complications, childbirth complications and other possible factors, the computer entered the data, verified the data into the SPSS17.0 analysis, quantitative data analysis using t test, qualitative data analysis using Pearson 2 test, test level alpha =0.05; data obeys normal distribution The difference was statistically significant by means of mean mean standard deviation (x + s), and the difference was statistically significant. Results: the maternal age of 1 ART group and NC group, educational background, residence, normal menstruation, previous production history and threatened abortion were compared: the average age of the mother in group ART was larger than that of the NC group, the first production, the lower education, the rural areas, and the irregular menstruation The proportion of the law and the history of threatened abortion was higher than that of the NC group. The difference was statistically significant between the birth weight of the.2 ART group and the NC group, the head circumference, the body length and the sex ratio: the average head circumference of the ART group, the average body length, and the average weight were less than the NC group, and the difference was statistically significant (P0.05), and there was no statistical difference between the two groups in the sex ratio of the offspring. The comparative results of the birth weight, head circumference and body length of the two groups of the two groups of single fetuses after.3 removal were compared: the average weight and average length of the single fetal foot and single preterm infants (no difference in gestational age) in the ART group were lower than those in the NC group, and the difference was statistically significant (P0.05), but there was no significant difference in the head circumference of the single fetus between the two groups (P0.05).4 ART group and the other group (P0.05). The comparison of multiple pregnancy, preterm birth and cesarean section in group NC: the rate of multiple pregnancy in group ART (65.3%), the rate of premature delivery (63.41%) and cesarean section rate (90.94%) were higher than that of group NC (4.6%, 24.39%, 77.35%), the difference was statistically significant (P0.05), and the incidence of ART for single fetal preterm (68.55%) was also higher than that of the single fetus NC group (25.95%), and the difference was statistically significant (P0.0 5) the comparison between the.5 ART group and the NC group during pregnancy: the ART group was higher than the NC group, and the difference was statistically significant (P0.05). Conclusion: the incidence of multiple pregnancy, premature delivery and caesarean birth is higher than that of the NC group. The incidence of single fetal premature birth after the removal of multiple fetal factors is still higher than that of NC group.2 ART group birth weight, head circumference, body length is obvious The birth weight and length of ART single fetus and single fetal preterm infants were still lower than those of the single fetus generation.3 ART of the corresponding natural pregnancy after removal of multiple fetal factors. The incidence of threatened abortion, pregnancy complication and complication in pregnancy was higher than that of the NC group. The second part assisted reproductive technology subgeneration. Study on the risk factors of low birth weight: to provide a more scientific basis for reducing the incidence of low birth body mass in Assisted reproductive technology (ART) subgeneration of low birth body mass (Low birth weight, LBW), and to provide a scientific basis for reducing the rate of low birth weight of ART subgeneration. By August 2014, 287 cases of all live births who had received ART pregnancy in our hospital and were hospitalized in our hospital, and all the living births of all the births for more than 28 weeks were the subjects of the experimental group. All cases of medical records receiving assisted reproductive technology were extracted from the reproductive center and obstetrics, which were in accordance with the standard cases, and the database was set up with EXCEL software to record the names of pregnant women. Number, age, education, long-term residence, way of pregnancy, treatment outcome, fetus number, birth time, pregnancy week, mode of delivery, birth time, abortion history, menstrual history, family history, sex of the newborn, birth weight, pregnancy complications, childbirth complications and so on, computer input data, verify the data and import data into SPSS 17 analysis, single factor analysis and analysis of Pearson 2 test, multiple factors using Logistic regression analysis, P0.05 was statistically significant difference. Results: 1 single factor analysis showed that the ART group of pregnant women age, education, long-term residence, time of birth, pregnancy complications, preterm birth and multiple births are related to the low birth weight of the offspring, these factors will be .2 multiple factor Logistic regression analysis of the birth weight of the offspring of different degrees showed that multiple births, premature rupture of membranes, associated preeclampsia and premature birth were associated with low birth weight of the offspring: multiple births, OR=3.225,95%CI=1.673~6.215, P0.001; intrapartum eclampsia, OR=3.845,95%CI=1.607~9.201, P=0.002, and premature rupture of the membranes. OR=2.294,95%CI=1.156~4.553, P=0.018, preterm, OR=11.018,95%CI=5.044~24.066, and P0.001.3 assisted reproductive techniques have no difference in the incidence of low birth weight in the ART subgeneration. Conclusion: 1 multiple births, preterm birth, pregnancy combined with eclampsia, premature rupture of fetal membranes as a risk factor for low birth weight of ART offspring,.2 assisted reproductive technology type is born to the offspring. There is no difference in weight.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R714.8

【参考文献】