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目的:了解辅助生育技术(ART)是否会增加双胎妊娠的产科并发症和围产儿风险。方法:回顾性分析产前检查及分娩的760例辅助生育受孕双胎孕妇(ART组)和764例自然受孕双胎孕妇(对照组)的妊娠期并发症及新生儿结局。结果:ART组孕妇平均年龄(32.7±3.5岁)高于对照组(30.0±3.7岁),差异有统计学意义(P<0.05);ART组前置胎盘、产后出血及妊娠期糖尿病发生率高于对照组,差异有统计学意义(P<0.05);ART组择期剖宫产率为85.52%,高于对照组(80.09%),其急诊剖宫产导致早产的比例低于对照组,差异有统计学意义(P<0.05);新生儿出生体质量、新生儿窒息率、先天畸形发生率及新生儿死亡率组间无统计学差异(P>0.05)。结论:ART在双胎妊娠中会增加前置胎盘、产后出血及妊娠期糖尿病的发生率,但并不增加其他产科主要并发症及围产儿风险,因此,辅助生育受孕双胎孕妇并无预防性减胎的必要。
Objectives: To understand if assisted reproductive technology (ART) increases the obstetric complications and perinatal risks of twin pregnancies. Methods: The complications of pregnancy and neonatal outcomes in 760 pregnant women with assisted reproductive pregnancy (ART group) and 764 pregnant women with spontaneous conception (control group) were retrospectively analyzed. Results: The average age of pregnant women in ART group (32.7 ± 3.5 years) was significantly higher than that of control group (30.0 ± 3.7 years) (P <0.05). The incidence of placenta previa, postpartum hemorrhage and gestational diabetes in ART group was high In the control group, the difference was statistically significant (P <0.05); ART group elective cesarean section rate was 85.52%, higher than the control group (80.09%), the proportion of emergency cesarean section lead to preterm birth was lower than the control group, the difference (P <0.05). Neonatal birth weight, neonatal asphyxia, congenital malformations and neonatal mortality were not significantly different between the two groups (P> 0.05). CONCLUSION: ART increases the incidence of placenta previa, postpartum hemorrhage and gestational diabetes in twin pregnancies, but does not increase other obstetric complications and the risk of perinatal complications, so ART is not preventable in pregnant women with twin pregnancies Tire reduction is necessary.