辅助生殖单胎妊娠与自然妊娠孕妇围产结局差异性研究  

A study on the difference of perinatal outcomes between assisted reproductive singleton pregnancy and natural pregnancy

作　　者：王飞[1] 庄丹燕[1] 潘婕文[1] 鲍幼维 潘小莉[1] 李海波 WANG Fei;ZHUANG Dan-yan;PAN Jie-wen;BAO You-wei;PAN Xiao-li;LI Hai-bo(Key Laboratory of Comprehensive Prevention and Treatment of Birth Defects,Ningbo Women’s and Children’s Hospital,Ningbo,Zhejiang 315012,China)

机构地区：[1]宁波市妇女儿童医院出生缺陷综合防治重点实验室,浙江宁波315012

出　　处：《中国卫生检验杂志》2021年第24期3024-3027,共4页Chinese Journal of Health Laboratory Technology

基　　金：宁波市公益类科技计划项目(202002N3150);浙江省医药卫生项目(2019KY621);科技创新团队(2014B82-003)。

摘　　要：目的调查辅助生殖技术(assisted reproductive technology,ART)与自然受孕筛查结果差异,探讨ART是否增加胎儿染色体异常率。方法将26593例单胎孕妇分为ART组(2313例)和对照组(随机选取同时间段内24280例自然妊娠孕妇),检测早孕期和中孕期生化指标,计算整合筛查风险。高风险孕妇知情同意进行绒毛或羊水染色体检测,所有对象随访妊娠结局。结果ART组年龄大于对照组(P<0.05)。早孕期妊娠相关蛋白A(PAPP-A)MOM及FreeHCGβMOM中位数ART组均低于对照组(P<0.05)。中孕期甲胎蛋白(AFP)MOM ART组高于对照组(P<0.05);Free-HCGβMOM ART组低于对照组,上述差异均有统计学意义(P<0.05)。ART组与对照组的整合筛查高风险率分别为2.5%和1.9%,两者差异有统计学意义(Z=3.9,P<0.05);但2组核型异常率差异无统计学意义(χ^(2)=0.072,P>0.05)。结论ART孕妇产前筛查生化指标与自然妊娠有差异,需增加矫正因子进行风险计算,ART并未增加胎儿染色体异常的风险。Objective To investigate the difference of screening results between assisted reproductive technology and natural pregnancy,and then to explore whether ART increased the risk of fetal chromosomal abnormalities.Methods A total of 26593 singleton pregnant women were divided into ART group(2313 cases)and control group(24280 cases of natural pregnancy in the same period were randomly selected).Biochemical markers of early pregnancy and mid pregnancy were detected,and integrated screening risk was calculated.High risk pregnant women informed consent for chorionic villus or amniotic fluid chromosome test,and all subjects were followed up for pregnancy outcomes.Results The age of ART group was higher than that of control group(P<0.05).The median of pregnancy-associated protein A(PAPP-A)MOM and free-HCGβMOM in early pregnancy group were lower than those in control group(P<0.05).The AFP of MOM ART group was higher than that of control group(P<0.05).Free-HCGβMOM ART group was lower than control group,with the differences statistically significant(P<0.05).The high risk rate of integrated screening in ART group and control group was 2.5%and 1.9%,respectively,and the difference was statistically significant(Z=3.9,P<0.05).However,there was no significant difference in the rate of abnormal karyotype between the two groups(χ^(2)=0.072,P>0.05).Conclusion The biochemical markers of prenatal screening of ART pregnant women were different from those of natural pregnancy,so correction factors should be added for risk calculation.Art did not increase the risk of fetal chromosomal abnormalities.

关 键 词：辅助生殖技术 自然妊娠 染色体异常 产前筛查 

分 类 号：R714.21[医药卫生—妇产科学]