IVF-ET妊娠成功后抱婴失败的影响因素Logistic回归分析  

Logistic Regression Analysis of Influencing Factors of Fetal Birth Failure after IVF-ET Successful Pregnancy

作　　者：陈昀 杨小杰[1] 何桦 高丹丽[1] 李桂荣[1] 王婧瑶 林黎明[3] CHEN Yun;YANG Xiaojie;HE Hua(Tangshan Maternal and Child Health Hospital, Hebei Tangshan 063000, China)

机构地区：[1]河北省唐山市妇幼保健院妇产科,河北唐山063000 [2]华北理工大学临床医学院实验中心,河北唐山063000 [3]河北省开滦总医院心内科,河北唐山063000

出　　处：《河北医学》2019年第5期764-769,共6页Hebei Medicine

基　　金：2018年度河北省医学科学研究重点课题计划,(编号:20181336)

摘　　要：目的:探讨影响体外受精-胚胎移植(IVF-ET)妊娠成功后抱婴失败的相关因素,并提出预防建议。方法:回顾性分析2015年8月至2018年1月在本院行IVF-ET妊娠成功后的247例孕妇的临床病例资料,根据是否抱婴成功将其分为成功组与失败组,并采用单因素分析及多因素Logistic回归分析法分析影响IVF-ET妊娠后抱婴成功的相关危险因素,且提出预防建议。结果:经随访,247例行IVF-ET妊娠成功后的孕妇共有206例抱婴成功,41例抱婴失败,抱婴失败率为16.60%;成功组不孕年限≥6年、原发不孕、有生产史、有宫外孕史、移植胚胎数≥2个、冻融周期胚胎移植、胚胎移植人工周期与控制性超排卵短方案、长方案、超长方案、拮抗剂方案的构成比与失败组比较差异均无统计学意义(P>0.05);成功组年龄≥35岁、有流产史、有辅助生殖史、有子宫手术史、HCG注射日子宫内膜厚度≤10mm、有抑郁情绪、LH/FSH>2及减胎术的构成比均明显低于失败组,差异均具有统计学意义(P<0.05),经Logistic回归分析发现这些因素均是影响行IVF-ET妊娠成功后抱婴成功的危险因素(OR=3.518、2.962、5.147、5.007、5.425、4.932、4.763、4.294,均P<0.05)。结论:高龄孕妇、流产史、辅助生殖史、子宫手术史、HCG注射日子宫内膜厚度≤10mm、抑郁情绪、LH/FSH>2及减胎术均是影响行IVF-ET妊娠成功后抱婴成功的危险因素,可增加抱婴失败风险,临床工作中需加强对此类患者的管理。Objective: To explore the related factors influencing the failure of fetal birth after successful pregnancy of vitro fertilization-embryo transfer (IVF-ET) and to put forward preventive suggestions. Methods: The clinical datas of 247 cases of pregnant women after successful pregnancy of IVF-ET in our hospital were retrospectively analyzed from August 2015 to January 2018, and the patients were divided into successful group and failure group according to hether or not success baby birth, then the risk factors of infant success after successful pregnancy of IVF-ET were analyzed by single factor analysis and multiple factor Logistic regression analysis method, and put forward the prevention suggestions. Results: After follow-up, there were 206 cases with success baby birth in the 247 cases after successful pregnancy of IVF-ET and there were 41 cases with failed baby birth, and the failure rate of live births was 16.60%. There was no significant difference of the constituent ratios of the infertility years ≥ 6 years, primary infertility, with birth history, with ectopic pregnancy history, the number of embryos transferred ≥ 2, embryo transfer during freeze-thaw cycles, artificial cycle of embryo transfer and the short protocol, long protocol, super long protocol and antagonist protocol of the control ovary hyperstimulating protocol between the successful group and the failure group (P>0.05). The constituent ratios of the age ≥ 35 years old, history of abortion, history of assisted reproduction, history of uterine surgery, endometrial thickness on HCG injection day ≤10mm, depression, LH/FSH > 2 and fetal reduction of the successful group were significantly lower than those of the failure group, and the differences were statistically significant (P<0.05), and Logistic regression analysis showed that these factors were the risk factors for successful baby birth of the patients after successful pregnancy of IVF-ET (OR = 3.518, 2.962, 5.147, 5.007, 5.425, 4.932, 4.763, 4.294, all Ps<0.05). Conclusion: Older pregna

关 键 词：体外受精-胚胎移植 抱婴失败 影响因素 

分 类 号：R714.8[医药卫生—妇产科学]