2015—2021年北京市辅助生殖技术助孕活产及高龄孕母占比与不良妊娠结局变化趋势  

Birth trends and adverse pregnancy outcomes of live births under assisted reproductive technology in Beijing,2015-2021

作　　者：张璐[1] 杨惠娟[1] 刘凯波[1] Lu Zhang;Huijuan Yang;Kaibo Liu(Beijing Obstetrics and Gynecology Hospital,Capital Medical University/Beijing Maternal and Child Health Care Hospital,Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院/北京妇幼保健院,北京100026

出　　处：《中华妇幼临床医学杂志（电子版）》2023年第1期46-53,共8页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

摘　　要：目的:探讨2015—2021年北京市活产出生人口中辅助生殖技术(ART)助孕变化趋势及不良妊娠结局。方法:提取北京市妇幼保健网络信息系统(BMCHINS)中2015—2021年的监测数据,对这7年间目前经ART助孕(以下简称为ART孕母)所分娩的活产儿(以下简称ART活产儿)早产、低出生体重、足月小样儿等不良妊娠结局,以及ART孕母高龄、多胎等不良结局危险因素的变化趋势进行回顾性分析。本研究遵循的程序符合2013年修订的《世界医学协会赫尔辛基宣言》要求。结果:①2015—2021年,BMCHINS共监测43485例ART活产儿及其36056例ART孕母。7年间,ART活产儿及其孕母所占比例上升趋势比较,差异均有统计学意义(χ^(2)=9292.59、8750.12,P<0.001)。②ART孕母年龄≥35岁、≥40岁的高龄孕妇占比分别为36.3%(13085/36056)和6.5%(2340/36056),显著高于全部孕母中≥35岁、≥40岁高龄孕妇占比[16.1%(224295/1389457)和2.0%(27983/1389457)],二者分别比较,差异均有统计学意义(χ^(2)=10279.08、3381.89,P均<0.001)。年龄≥35岁和≥40岁的高龄孕母中经ART助孕率上升趋势比较,差异有统计学意义(χ^(2)=1954.96,317.91,P均<0.001)。③ART活产儿中多胎率为34.3%(14913/43485),显著高于全部活产儿的3.1%(44106/1411926),并且差异有统计学意义(χ^(2)=105349.58,P<0.001)。7年间,多胎活产儿中经ART助孕比例上升趋势比较,差异有统计学意义(χ^(2)=1542.36,P<0.001)。④ART活产儿中胎龄<37周和<32周早产率分别为20.6%(8967/43485)和2.7%(1153/43485),显著高于全部活产儿的6.1%(85481/1411926)和0.6%(8274/1411926),并且差异均有统计学意义(χ^(2)=14750.94、2796.68,P<0.001)。7年间早产儿中经ART助孕比例上升趋势分别比较,差异有统计学意义(χ^(2)=926.96,74.16,P<0.001)。⑤7年间,出生体重<2500 g和<1500 g者中经ART助孕率上升趋势比较,差异有统计学意义(χ^(2)=804.68、66.79,P<0.001)。结论:ART对北京市活产出生人口的贡献率�Objective To explore the changing trend of assisted reproductive technology(ART)conceptions and adverse pregnancy outcomes among the live birth population in Beijing from 2015-2021.Methods The monitoring data of Beijing Maternal and Child Health Network Information System(BMCHINS)from 2015 to 2021 were extracted,and the trends of adverse pregnancy outcomes such as premature birth,low birth weight,full-term small baby and other risk factors of adverse outcomes of live births(hereinafter referred to as ART mothers)conceived by ART during these seven years were analyzed retrospectively.The study was conducted in accordance with World Medical Association Declaration of Helsinki revised in 2013.Results①From 2015 to 2021,a total of 43485 ART live births and 36056 ART mothers were monitored by BMCHINS.During these seven years,the proportion of ART live-born children and their mothers increased,and the differences were statistically significant(χ^(2)=9292.59,8750.12;P<0.001).②The proportions of ART older pregnant women aged≥35 years and≥40 years were 36.3%(13085/36056)and 6.5%(2340/36056),respectively,which were significantly higher than those among all mothers[16.1%(224295/1389457)and 2.0%(27983/1389457)],with statistically significant differences(χ^(2)=10279.08,3381.89;P<0.001).The difference was statistically significant when comparing the increasing trend of ART conception rate among older mothers aged≥35 years and≥40 years(χ^(2)=1954.96,317.91;P<0.001).③The rate of multiple births among ART live births was 34.3%(14913/43485),which was significantly higher than 3.1%of all live births(44106/1411926),and the difference was statistically significant(χ^(2)=105349.58,P<0.001).The increasing trend in the rate of ART births among multiple live births over 7 years was compared with a statistically significant(χ^(2)=1542.36,P<0.001).④The preterm birth rates among ART live births at gestational age<37 weeks and<32 weeks were 20.6%(8967/43485)and 2.7%(1153/43485),respectively,which were significantly higher

关 键 词：生殖技术 辅助 婴儿 早产 婴儿 出生时低体重 孕母年龄 妊娠 多胎 婴儿 小于胎龄 孕妇 

分 类 号：R714.8[医药卫生—妇产科学]