试管婴儿的出生缺陷及围产期情况研究  

Study on the neonatal outcomes and congenital malformations in children born after in-vitro fertilization

作　　者：王雪梅[1] 常艳美[1] 赵晓艳 童笑梅[1] 孙晓菲[1] 

机构地区：[1]北京大学第三医院儿科,100083 [2]甘肃兰化职工医院儿科

出　　处：《中华围产医学杂志》2005年第4期246-250,共5页Chinese Journal of Perinatal Medicine

摘　　要：目的探讨试管婴儿发生先天畸形、围产期合并症及死亡的危险性。方法对1994年7月至2003年10月在我院接受IVF-ET术的156例母亲所生活产婴儿211例(试管婴儿组),及同期分娩的与母亲年龄及分娩时间相当的213例正常受孕母亲所生婴儿218例(对照组)进行分析,比较两组的母亲妊娠合并症及是否多胎、胎儿窘迫和出生窒息、出生缺陷、生后合并症、转儿科住院及存活情况。结果试管婴儿组的多胎妊娠、早产及剖宫产率均显著高于对照组,分别为37.2%和2.3%,37.2%和8.5%、97·0%和71.8%(P均<0.01);妊高征、早期先兆流产率显著高于对照组,分别为22.4%和10.8%(P<0.01),4.5%和0%(P<0.01);对照组胎儿窘迫的发生率显著高于试管婴儿组,14.6%和4.5%。试管婴儿组心脏畸形率和畸形总数皆高于对照组,但未显示出统计学差异。结论试管婴儿的多胎率明显增高,由此造成的相关的围产期合并症发生率也随之增高。Objective To evaluate the neonatal outcomes and the prevalence of congenital malformations in children born after in-vitro fertilization（IVF）. Methods IVF children （211 cases） born of 156 mothers from July 1994 to October 2003 and 218 controls were studied. Those controls were randomly chosen from the same hospital matched for the time and season of birth and maternal age. Results The incidence of multi-gestation （37.2 % vs 2.3%, OR= 24.62, 95% CI： 9.1-72）, pretermbirth （37.2% vs 8. 5%, OR=6.41, 95% CI： 3. 5-12.0）, cesarean section （97.0% vs 71.8%, OR=14.9,95 % CI ： 5.0-49.5）, pregnancy-induced hypetension （22.4 % vs 10.8 %, OR 2.39,95% CI：L 3-4.9） , threatened abortion （4.5% vs 0%, OR=3. 11.95% CI：2.0-4.8） were significantly higher in the IVF group, but the prevalcnce of fetal distress （14.6% vs 4.5% ） was lower comparing with control group（P（0.01）. The amount and the prevalence of heart malformations was higher in the IVF population than control group, but no statistic significance was shown. Conclusions Neonatal outcomes after IVF is worse than the general population mainly due to the large proportion of multigestation after IVF. The higher prevalence of heart malformations does not solely arise from multiplicity but from other causes.

关 键 词：受精 体外 胚胎移植 围生医学 畸形 试管婴儿 出生缺陷 围产期 妊娠合并症 IVF-ET术 母亲年龄 

分 类 号：R714.7[医药卫生—妇产科学]