辅助生殖与自然受孕双胎妊娠围产结局比较——附1524例临床分析

发布时间：2019-04-01 23:13

【摘要】：目的:了解辅助生育技术(ART)是否会增加双胎妊娠的产科并发症和围产儿风险。方法:回顾性分析产前检查及分娩的760例辅助生育受孕双胎孕妇(ART组)和764例自然受孕双胎孕妇(对照组)的妊娠期并发症及新生儿结局。结果:ART组孕妇平均年龄(32.7±3.5岁)高于对照组(30.0±3.7岁),差异有统计学意义(P0.05);ART组前置胎盘、产后出血及妊娠期糖尿病发生率高于对照组,差异有统计学意义(P0.05);ART组择期剖宫产率为85.52%,高于对照组(80.09%),其急诊剖宫产导致早产的比例低于对照组,差异有统计学意义(P0.05);新生儿出生体质量、新生儿窒息率、先天畸形发生率及新生儿死亡率组间无统计学差异(P0.05)。结论:ART在双胎妊娠中会增加前置胎盘、产后出血及妊娠期糖尿病的发生率,但并不增加其他产科主要并发症及围产儿风险,因此,辅助生育受孕双胎孕妇并无预防性减胎的必要。
[Abstract]:Objective: to investigate whether assisted fertility technology (ART) increases obstetric complications and perinatal risk in twin pregnancies. Methods: the complications of pregnancy and neonatal outcome were retrospectively analyzed in 760 pregnant women with assisted pregnancy (ART group) and 764 naturally pregnant twins (control group) during prenatal examination and delivery. Results: the average age of pregnant women in ART group (32.7 卤3.5yr) was higher than that in control group (30.0 卤3.7yr), the difference was statistically significant (P0.05). The incidence of placenta previa, postpartum hemorrhage and gestational diabetes mellitus in ART group was significantly higher than that in control group (P0.05). The rate of elective cesarean section in ART group was 85.52%, which was higher than that in control group (80.09%). The rate of premature delivery in emergency cesarean section group was lower than that in control group (P0.05). There was no significant difference in birth mass, neonatal asphyxia rate, incidence of congenital malformation and neonatal mortality between the two groups (P0.05). Conclusion: ART increases the incidence of placental previa, postpartum hemorrhage and gestational diabetes mellitus in twin pregnancies, but does not increase other major obstetric complications and perinatal risk. There is no need for preventive reduction of pregnancy to assist pregnant twins.
【作者单位】：上海交通大学医学院附属国际和平妇幼保健院;
【基金】：上海市卫生和计生委重点项目,项目号:201540377
【分类号】：R714.8

【共引文献】