不同试管婴儿技术及其与妊娠期高血压疾病关系的研究

发布时间：2018-12-25 17:57

【摘要】：目的分析接受试管婴儿技术的患者特征,探讨不同试管婴儿技术与妊娠期高血压疾病的关系。方法收集浙江大学医学院附属妇产科医院生殖科及产科住院资料,回顾性分析683例接受试管婴儿技术成功生育的不孕患者的特点,比较不同试管婴儿技术下妊娠期高血压疾病的发生率。结果所有683例患者中,接受常规IVF (In Vitro Fertilization)受精的患者391例(57.2%),接受ICSI(Intracytoplasmic Sperm Injection)受精的患者292例(42.8%),新鲜周期胚胎移植受孕的患者463例(67.8%),冷冻周期胚胎移植受孕的患者220例(32.2%)。妊娠期高血压疾病共有58例(8.5%),其中妊娠期高血压22例(3.2%),子痫前期35例(5.1%),子痫1例(0.1%)。不孕年数增加导致妊娠期高血压风险增加,OR为1.16(1.04-1.30)；体重指数增加导致子痫前期风险增加,OR为1.16(1.03-1.30)。ICSI方式受精与常规IVF相比,患妊娠期高血压的OR为1.99(0.84-4.71),多因素校正后减小为1.71(0.71-4.11),患子痫前期的OR为1.14(0.58-2.26),多因素校正后减小为1.11(0.55-2.23)。双胎组中,ICSI方式受精与常规IVF相比,患妊娠期高血压的OR为5.27(1.07-26.0),有显著性差异,多因素校正后减小为4.47(0.87-22.96)。在单胎组中未发现显著性关联。冷冻周期胚胎移植与新鲜周期胚胎移植相比,患妊娠期高血压的OR为0.46(0.15-1.37),多因素校正后为0.51(0.17-1.54),患子痫前期的OR为0.96(0.46-2.00),多因素校正后为1.00(0.47-2.09),关联均无显著性。结论接受试管婴儿技术受孕的孕妇患妊娠期高血压的风险可能随不孕年数增加而增加,患子痫前期的风险可能随体重指数的增加而增加。ICSI受精技术可能增加妊娠期高血压发病风险。而胚胎移植前是否经过冻融,则与妊娠期高血压疾病发生无明显关系。其背后的机制依赖更多的前瞻性及基础研究。
[Abstract]:Objective to analyze the characteristics of patients undergoing IVF technique and to explore the relationship between IVF technique and hypertensive disorder complicating pregnancy. Methods the data of reproductive department and obstetrics department in Department of Obstetrics and Gynecology affiliated to Zhejiang University Medical College were collected and the characteristics of 683 infertile patients who were successfully delivered by IVF were analyzed retrospectively. To compare the incidence of hypertensive disorder complicating pregnancy with different IVF techniques. Results among the 683 patients, 391 (57.2%) received conventional IVF (In Vitro Fertilization) fertilization, 292 (42.8%) received ICSI (Intracytoplasmic Sperm Injection) fertilization. 463 cases (67.8%) were pregnant with fresh cycle embryo transfer and 220 cases (32.2%) with frozen cycle embryo transfer. There were 58 cases (8.5%) of hypertensive disorder complicating pregnancy, among which 22 cases (3.2%) were gestational hypertension, 35 cases (5.1%) were preeclampsia, and 1 case (0.1%) was eclampsia. The risk of hypertension complicating pregnancy was increased by increasing the number of infertile years, OR was 1.16 (1.04-1.30); Increased body mass index (BMI) increased the risk of preeclampsia. OR was 1.16 (1.03-1.30). ICSI), compared with conventional IVF, OR was 1.99 (0.84-4.71). The OR of preeclampsia was 1.14 (0.58-2.26) and 1.11 (0.55-2.23) after multifactor correction. In the twin group, the OR of hypertensive complicating pregnancy was 5.27 (1.07-26.0) in ICSI mode fertilization and 4.47 (0.87-22.96) after multi-factor correction. No significant association was found in single fetus group. Compared with fresh cycle embryo transfer, the OR was 0.46 (0.15-1.37) and 0.51 (0.17-1.54), respectively. The OR of preeclampsia was 0. 96 (0. 46-2. 00), and the multivariate correction was 1. 00 (0. 47-2. 09). Conclusion the risk of hypertension complicating pregnancy may increase with the number of infertility years. The risk of preeclampsia may increase with the increase of BMI. ICSI fertilization may increase the risk of hypertension complicating pregnancy. Whether the embryo was frozen or thawed before embryo transfer had no obvious relationship with hypertensive disorder complicating pregnancy. The underlying mechanism relies on more forward-looking and basic research.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.8;R714.246

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