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  

Comparison of the obstetric and perinatal outcomes of twin pregnancies conceived following assisted reproductive technologies versus conceived spontaneously

作　　者：潘漪莲[1] 张艳[1] 陆海茜 于静波[1] 王彦林[1] 

机构地区：[1]上海交通大学医学院附属国际和平妇幼保健院,上海200030

出　　处：《生殖与避孕》2015年第10期724-729,共6页Reproduction and Contraception

基　　金：上海市卫生和计生委重点项目;项目号:201540377

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(P<0.05);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(P<0.05);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(P<0.05);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(P>0.05)。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。Objective： To find out whether assisted reproductive techniques（ART） further increase the risks ofobstetric and perinatal outcomes of twin pregnancies. Methods： A retrospective study was carried out to obtain the perinatal complications and neonatal outcomes of twin pregnancies receiving by ART（ART group, n=760）and those conceived spontaneously（SC）（control group, n=764）. Results： Women age in ART group was older than that in control group（32.7 ± 3.5 years vs 30.0 ± 3.7 years, P〈0.05）. The incidence of placenta previa, postpartum hemorrhage and gestational diabetes were increased in assisted-reproduction twin pregnancies（P〈0.05）. Both groups of pregnant women were likely to choose cesarean section. Cesarean sections were more frequently performed in ART group than that in control group（85.52% vs 80.09%）, but the rate of premature emergency cesarean was lower in ART group, the difference between the two groups was statistically significant（P〈0.05）. There was no statistically significant differences in fetal birth weight, neonatal asphyxia,fetal congenital malformations and neonatal mortality between the two groups（P〉0.05）. Conclusion： ART in twin pregnancy will increase the risk of placenta previa, postpartum hemorrhage and gestational diabetes, but not increase other obstetrical complications and perinatal risk. It is not necessary to fetal reduction prevently for patients with assisted reproduction twin pregnancies.

关 键 词：双胎妊娠 辅助生育技术(ART) 自然妊娠 妊娠结局 

分 类 号：R714.8[医药卫生—妇产科学]