辅助生殖技术受孕对双绒毛膜双羊膜囊双胎妊娠早产发生风险的影响研究  

Effect of assisted reproductive technology conception on the risk of premature delivery in twin pregnancy

作　　者：吴凯佳 贾燕 张国华[1] 王亚男[1] 张晶 WU Kai-jia;JIA Yan;ZHANG Guo-hua;WANG Ya-nan;ZHANG Jing(The Fourth Hospital of Shijiazhuang,Shijiazhuang 050011,China)

机构地区：[1]石家庄市第四医院,河北石家庄050011

出　　处：《中国实用妇科与产科杂志》2024年第2期235-238,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：河北省科技厅民生科技专项(20377793D)。

摘　　要：目的探讨辅助生殖技术(assisted reproductive technology,ART)受孕对双绒毛膜双羊膜囊双胎妊娠早产发生风险的影响。方法回顾性分析2018年1月至2022年12月于石家庄市第四医院产检并分娩至少一胎活产的双绒毛膜双羊膜囊双胎妊娠2501例。依据受孕方式,分为自然受孕组(n=1223)和ART组(n=1278),比较两组早产发生率及早产儿不良结局事件发生比例。结果ART组早产发生率显著高于自然受孕组(52.35%vs.48.24%,P<0.05)。根据不同分娩孕周对比,ART组早期早产(28~31+6孕周)发生率显著高于自然受孕组(13.75%vs.7.80%),晚期早产(34~36+6孕周)发生率低于自然受孕组(71.15%vs.77.80%),差异具有统计学意义(P<0.05)。ART组早产产妇的平均年龄及初产妇占比均高于自然受孕组,孕次低于自然受孕组,差异有统计学意义(P<0.05),ART组早产中自发性早产发生率较自然受孕组高。与自然受孕组相比,ART组早产儿出生体重更低,入住新生儿重症监护病房(NICU)率更高,住院时间更长,差异有统计学意义(P<0.05);而一胎胎死宫内发生率、早产儿死亡率以及早产儿窒息率未见统计学差异(P>0.05)。结论与自然受孕相比,ART受孕方式可显著增加双绒毛膜双羊膜囊双胎妊娠早产发生率,尤其增加孕32周前早期早产的发生以及自发性早产的发生,同时ART早产儿出生体重更低,入住NICU率高、住院时长偏长。因此,对ART受孕的双绒毛膜双羊膜囊双胎孕妇应加强孕期保健及管理,积极预防早期早产的发生。Objective To investigate the effect of assisted reproductive technology(ART)conception on the risk of premature delivery in dichorionic-diamniotic twin pregnancy.Methods A retrospective study was preformed in 2501 women with dichorionic-diamniotic(DCDA)twin pregnancies who delivered at least one live birth(n=2501)in the fourth Hospital of Shijiazhuang from January 2018 to December 2022.The incidence of preterm birth and premature adverse outcome events were compared between the natural conception group(n=1223)and the ART group(1278).Results The incidence of preterm birth in ART group was significantly higher than that in natural conception group(52.35%vs.48.24%,P<0.05).The incidence of early preterm birth(28 to 31~(+6)weeks of gestation)was significantly higher in the ART group than in the natural conception group(13.75%vs.7.80%),while the incidence of late preterm birth(34 to 36~(+6)weeks of gestation)was lower than in the natural conception group(71.15%vs 77.80%,P<0.05).The mean age and proportion of primiparous women in the ART group were higher than those in the natural conception group,and the pregnancy frequency was lower than that in the natural conception group,the difference being statistically significant(P<0.05),and the incidence of spontaneous preterm birth in the ART group was higher than that in the natural conception group.Compared with the natural conception group,the premature infants in ART group had lower birth weight,higher rate of admission to NICU,and longer hospital stay(P<0.05).However,there were no statistically significant differences in the incidence of intrauterine death of one twin,premature infant mortality,or premature infant asphyxia(P>0.05).Conclusions Compared with natural conception,ART conception can significantly increase the incidence of preterm birth in double chorionic twin pregnancies,especially the incidence of early preterm birth before 32 weeks of gestation and the incidence of spontaneous preterm birth.ART preterm babies have lower birth weight,higher rate of admission

关 键 词：双胎妊娠 早产 辅助生殖技术 双绒毛膜双羊膜囊双胎 

分 类 号：R714.7[医药卫生—妇产科学]