新鲜周期卵裂胚和囊胚移植单胎分娩的新生儿结局及影响因素  

Analysis of the outcome of single-birth newborns with fresh-cycle cleavage embryo and blastocyst transplantation

作　　者：刘文霞[1] 杜明泽 刘曼曼[1] 李嘉恒[1] 管一春[1] 王兴玲[1] LIU Wen-xia;DU Ming-ze;LIU Man-man;LI Jia-heng;GUAN Yi-chun;WANG Xing-ling(Reproductive Medicine Center,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China)

机构地区：[1]郑州大学第三附属医院生殖医学中心

出　　处：《新乡医学院学报》2019年第9期868-871,共4页Journal of Xinxiang Medical University

摘　　要：目的分析新鲜周期体外受精(IVF)-胚胎移植治疗中移植卵裂胚和囊胚后单胎分娩的新生儿结局及其影响因素。方法回顾性分析2014年1月至2016年6月郑州大学第三附属医院生殖医学中心接受IVF/卵胞浆质内单精子注射(ICSI)助孕单胎分娩的1371例不孕症患者的临床资料及分娩新生儿信息,根据移植胚胎体外培养时间将患者分为囊胚组(n=181例)和卵裂胚组(n=1190例),比较2组新生儿的早产率、出生体质量、出生缺陷等指标,并对新生儿主要观察指标影响因素进行分析。结果囊胚组早产(PTB)比例高于卵裂胚组(P<0.05);2组剖宫产比例、分娩孕周及极早产儿、低出生体质量儿、极低出生体质量儿、大于胎龄儿(LGA)、小于胎龄儿(SGA)及出生缺陷比例比较差异均无统计学意义(P>0.05)。Logistic回归分析显示,囊胚移植及母亲年龄与新生儿PTB相关(P<0.05),不孕类型、产次、母亲体质量指数与LGA有关(P<0.05),母亲体质量指数与SGA有关(P<0.05)。结论新鲜周期囊胚移植可增加新生儿PTB发生率,不孕症患者的体质量指数是影响新生儿出生体质量的一个重要因素。Objective To analyze the outcome of single-birth newborns with fresh-cycle cleavage embryo and blastocyst transplantation in in vitro fertilization and embryo transfer(IVF-ET) treatment and its influencing factors. Methods The clinical data of 1 371 infertile women who received IVF/intracytoplasmic sperm injection(ICSI) in the Reproductive Medicine Center of the Third Affiliated Hospital of Zhengzhou University from January 2014 to June 2016 and neonatal information were analyzed retrospectively. The patients were divided into blastocyst group(n = 181) and cleavage embryo group(n = 1 190)according to the culture time in vitro of transplanted embryos. The preterm birth(PBT) rate,birth weight,birth defects and other indicators were compared between the two groups,and the influencing factors of the main observation indicators of the newborns were analyzed. Results The rate of PTB of newborn in blastocyst group was higher than that in the cleavage embryo group(P < 0. 05);there was no statistic difference in the cesarean section rate,gestational week of childbirth and very premature infants(VPTB),low birth weight(LBW),very low birth weight(VLBW),large for gestational age infant(LGA),small for gestational age infants(SGA) and birth defects between the two groups(P > 0. 05). Logistic regression analysis showed that blastocyst transplantation and maternal age were correlated with PTB of newborn(P < 0. 05);the infertility type,delivery times and body mass index of parturient were correlated with LGA(P < 0. 05);the body mass index of parturient was correlated with SGA(P < 0. 05). Conclusion Fresh cycle blastocyst transplantation can increase the incidence of PTB in neonates. Body mass index of infertility patients is an important influence factor on the birth weight of newborns.

关 键 词：新鲜周期 囊胚 卵裂胚 新生儿结局 

分 类 号：R711.6[医药卫生—妇产科学]