新鲜周期体外受精-胚胎移植后子代单胎活产儿中小于胎龄儿的发生率及危险因素分析  

Incidence and risk factors of small for gestational age infants among living singletons after in vitro fertilization and fresh embryo transfer

作　　者：张琼 高睿[1] 陈明丽 刘秀美 秦朗[1] ZHANG Qiong;GAO Rui;CHEN Mingli;LIU Xiumei;QIN Lang(The Reproductive Medical Center,Department of Obstetrics and Gynecology,Key Laboratory of Birth Defects and Related of Women and Children of Ministry of Education,West China Second University Hospital,Sichuan University,Chengdu 610041,China;Ziyang Maternal and Child Health Care Hospital,Ziyang Women and Children Hospital,West China Second University Hospital,Sichuan University,Ziyang 641300,Sichuan,China)

机构地区：[1]四川大学华西第二医院妇产科生殖医学中心·出生缺陷与相关妇儿疾病教育部重点实验室,四川成都610041 [2]资阳市妇幼保健院·四川大学华西第二医院资阳妇女儿童医院,四川资阳641300

出　　处：《西部医学》2024年第1期97-102,共6页Medical Journal of West China

基　　金：四川省科技厅项目(2022ZYD0067)。

摘　　要：目的探究女性接受新鲜周期体外受精/卵母细胞内单精子注射(IVF/ICSI)-胚胎移植(ET)助孕后子代单胎活产儿中不同程度小于胎龄儿(SGA)的发生率及危险因素。方法回顾性收集2014年4月-2020年12月于四川大学华西第二医院接受新鲜周期IVF/ICSI-ET助孕并分娩单胎活产儿的2262例患者的临床资料,根据子代出生体重在同性别、同胎龄新生儿中的百分位数将患者分为正常组(第10~第90百分位)、轻中度SGA组(第3~第10百分位)和重度SGA组(小于第3百分位)。比较不同程度SGA组与正常组患者病史及IVF/ICSI-ET相关临床资料的差异,采用多因素logistic回归筛选不同程度SGA的危险因素。结果女性接受新鲜周期IVF/ICSI-ET助孕后分娩的单胎活产儿中SGA的发生率为9.9%,其中轻中度SGA的发生率为5.0%、重度SGA的发生率为4.9%。BMI<18.5 kg/m^(2)、有自然流产史为子代发生轻中度SGA的危险因素(校正OR=4.54和1.91,95%CI=1.78~11.55和1.18~3.10);有自然流产史、早产为子代发生重度SGA的危险因素(校正OR=2.80和2.22,95%CI=1.78~4.42和1.23~3.98)。有活产史为子代发生轻中度及重度SGA的保护因素。结论接受新鲜周期IVF/ICSI-ET助孕的患者中,BMI<18.5 kg/m^(2)、有自然流产史、早产者子代发生SGA的风险增加,临床工作中应予以关注。Objective To explore the incidence and risk factors for different degrees of small for gestational age(SGA) infants among living singletons after in invitro fertilization/intracytoplasmic sperm injection(IVF/ICSI) and fresh embryo transfer(ET) cycles.Methods A retrospective study involving 2262 singletons by IVF/ICSI and fresh ET from Apr.2014 to Dec.2020 were performed in West China Second University Hospital,Sichuan University.Participants were divided into mild-to-moderate SGA group and severe SGA group according to percentile of offspring birth weight among newborns of the same sex and gestational age.The clinical characteristics related to IVF/ICSI-ET were compared between different degrees of SGA groups and healthy group.Logistic regression analyses were performed to find IVF/ICSI-ET related risk factors of different degrees of SGA.Results The incidence of SGA among living singletons after IVF/ICSI and fresh ET treatment was 9.9%,among which the incidence of mild-to-moderate SGA was 5.0% and severe SGA was 4.9%.BMI <18.5 kg/m^(2) and history of spontaneous abortion were risk factors of mild-to-moderate SGA(adjusted OR=4.54 and 1.91,95%CI=1.78~11.55 and 1.18~3.10);history of spontaneous abortion and premature birth were risk factors of severe SGA(adjusted OR=2.80 and 2.22,95%CI=1.78~4.42 and 1.23~3.98).The history of live birth was protective factor of SGA.Conclusion For patients concepted by IVF/ICSI and fresh ET,BMI < 18.5 kg/m^(2),history of spontaneous abortion and premature birth were risk factors of SGA,which should be concerned in clinical works.

关 键 词：小于胎龄儿 辅助生育技术 体外受精 卵母细胞内单精子注射 胚胎移植 

分 类 号：R713[医药卫生—妇产科学]