基于前瞻性队列研究体外受精-胚胎移植对不良妊娠结局的影响  

Impact of in vitro fertilization-embryo transfer on adverse pregnancy outcomes: A prospective cohort study

作　　者：赵丽娟 陈立章[1] 王婷婷[1] 陈乐陶 郑赞 张森茂 叶子薇 秦家碧[1] ZHAO Lijuan;CHEN Lizhang;WANG Tingting;CHEN Letao;ZHENG Zan;ZHANG Senmao;YE Ziwei;QIN Jiabi(Department of Epidemiology and Health Statistics,Xiangya School of Public Health,Central South University,Changsha 410078,China)

机构地区：[1]中南大学湘雅公共卫生学院流行病与卫生统计学系,长沙410078

出　　处：《中南大学学报（医学版）》2018年第12期1328-1336,共9页Journal of Central South University ：Medical Science

基　　金：国家自然科学基金(81803313);湖南省自然科学基金(2018JJ2551)~~

摘　　要：目的:评价体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)技术本身是否会增加子代不良妊娠结局(adverse pregnancy outcomes,APOs)的风险。方法:选择诊断为不孕症通过IVF-ET受孕的妇女为暴露组,诊断为不孕症但通过非辅助生殖技术治疗(如促排卵或简单药物治疗)后自然怀孕的妇女作为非暴露组,建立前瞻性队列。通过单因素分析找出两组除IVF-ET操作因素外存在差异的因素,再采用多因素logistic回归分析控制这些因素,分析IVF-ET技术对APOs的独立作用。结果:多因素logistic回归分析显示,在控制混杂因素后,IVF-ET受孕孕妇较诊断为不孕症但自然受孕孕妇显著增加早产(OR=1.28,95%CI:1.05～1.56)、低出生体重(OR=1.69,95%CI:1.27～2.31)、围生期死亡(OR=5.33,95%CI:2.44～11.81)和先天畸形(OR=1.83,95%CI:1.12～2.94)的风险。结论:IVF-ET操作因素本身可能会增加APOs的风险。Objective: To evaluate whether the in vitro fertilization-embryo transfer (IVF-ET) procedures could increases the risks of adverse pregnancy outcomes (APOs) in off spring. Methods: A hospital-based prospective cohort design was conducted, which contained a control group of singleton pregnancies with indicators of subfertility who were still conceived naturally aft er using simple medical treatment (e.g. minimal medical intervention or ovulation induction), and an exposure group consisted of singleton pregnancies who had a history of infertility and IVFET treatment. All factors different between two groups in the univariate analysis were included in the multivariable logistic regression to evaluate the independent effect of IVF-ET procedures themselves on APOs. Results: After controlling for confounding factors by using multivariate logistic regression analysis, our results showed that pregnancies after IVF-ET experienced a higher risk of preterm birth (OR=1.28, 95% CI 1.05 to 1.56), low birth weight (OR=1.69, 95% CI 1.27 to 2.31), perinatal mortality (OR=5.33, 95% CI 2.44 to 11.81), and congenital malformations (OR=1.83, 95% CI 1.12 to 2.94). Conclusion: The IVF-ET operational factors may increase the risk of APOs.

关 键 词：体外受精-胚胎移植 不良妊娠结局 队列研究 

分 类 号：R714.8[医药卫生—妇产科学]