多胎减胎后单胎分娩与单胎妊娠分娩比较分析

发布时间：2018-12-28 17:37

【摘要】：目的探讨体外受精-胚胎移植(IVF-ET)助孕单胎分娩者中,孕早期多胎妊娠自然减胎及手术减胎对围产期母儿结局的影响。方法回顾性分析3 376例行IVF助孕治疗,新鲜或冷冻胚胎移植后单胎分娩者的临床资料,根据孕早期宫内孕囊数分组:A组(多胎妊娠,455例),其中A1组(手术减胎,34例),A2组(自然减胎,421例);B组(单胎妊娠,2 921例);分年龄进行组间临床基本资料,出生低体质量儿率、新生儿畸形率、妊娠期并发症等围产期母婴结局的比较。结果 (1)35岁的患者中,A组比B组不孕时间短、移植胚胎数多和优质胚胎数多;(2)囊胚移植比例、冷冻胚胎移植比例A、B组间均无统计学差异;(3)A1组和A2组出生低体质量儿率、出生极低体质量儿率、胎儿畸形率均显著高于B组(P0.05),但A1、A2组间无统计学差异(P0.05),A2组早产率明显增加,与B组有统计学差异(P0.01)。结论多胎妊娠即使减胎后单胎分娩,其新生儿低体质量及畸形风险仍高于单胎妊娠分娩者,35岁、不孕时间短者,建议选择性单优质胚胎移植,以降低多胎妊娠。
[Abstract]:Objective to investigate the effect of spontaneous reduction of early multiple pregnancy and surgical reduction on perinatal outcome in patients with single pregnancy assisted by in vitro fertilization and embryo transfer (IVF-ET). Methods the clinical data of 3 376 patients undergoing IVF assisted pregnancy therapy and single pregnancy after fresh or frozen embryo transfer were retrospectively analyzed. According to the number of intrauterine pregnancy sacs in the first trimester of pregnancy, group A was divided into two groups: group A (multiple pregnancy, 455 cases), including A1 group (34 cases). Group A2 (421 cases); In group B (single pregnancy, 2921 cases), the perinatal outcome of perinatal period, such as basic clinical data, low birth weight infant rate, neonatal malformation rate, pregnancy complications and so on, were compared with each other. Results (1) in 35 years old patients, the time of infertility in group A was shorter than that in group B, the number of embryos transferred and the number of high-quality embryos were more, (2) the ratio of blastocyst transfer and frozen embryo transfer was not significantly different between group A and group B; (3) the rate of low birth weight, very low birth weight and fetal malformation in group A1 and group A2 were significantly higher than those in group B (P0.05), but there was no significant difference between group A _ 1 and A _ 2 (P0.05), and the rate of premature delivery in group A _ 2 was significantly higher than that in group B (P0.05). There was statistical difference between group B and group B (P0.01). Conclusion the low body mass and the risk of malformation of multiple pregnancy after single child delivery are still higher than those of single pregnancy, 35 years old and short time of infertility. It is suggested that selective single high quality embryo transfer should be used to reduce multiple pregnancy.
【作者单位】：上海交通大学医学院附属仁济医院生殖医学中心上海市辅助生殖与优生重点实验室;
【基金】：国家自然科学基金面上项目(81571499),国家自然科学基金(81300547) 上海市教育委员会高峰高原学科建设计划(20161413) 国家973子课题(2014CB943300) 卫生计生委公益项目子课题(201402004) 上海市辅助生殖与优生重点实验室(17DZ2271100)~~
【分类号】：R714.8

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