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目的回顾性分析西南医院生殖医学中心1 237例胚胎移植术后母儿的围产结局。方法收集整理2011年1月至2014年7月在我中心行体外受精/卵胞浆内单精子显微注射(in vitro fertilization/intracytoplasmic sperm injection,IVF/ICSI)助孕技术成功妊娠的孕妇1 237例(助孕组),其中鲜胚移植周期711例,冻融胚胎移植周期(frozen thawed embryo transfer,FET)526例,以同期我院收治的自然妊娠孕妇(5 040例)作为对照,分组比较母亲围产期情况及新生儿出生结局。结果助孕组年龄为(30.4±4.2)岁,明显高于对照组(P<0.05);助孕组多胎率及剖宫产率较对照组明显升高(P<0.05);助孕组孕周及新生儿平均体质量较对照组明显偏小(P<0.05);助孕组妊娠期高血压(pregnancy-induced hypertension,PIH)、前置胎盘、妊娠期肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)、产后出血、母亲入ICU、新生儿住院、低体质量儿、早产以及新生儿入ICU(neonatal ICU,NICU)发生率较对照组明显升高(P<0.05),而胎盘早剥、胎膜早破(premature rupture of fetal membranes,PROM)、先兆子痫、死胎、新生儿死亡及新生儿畸形的发生率两组比较差异无统计学意义。在助孕组内,鲜胚组孕周及新生儿体质量较FET组小(P<0.05),鲜胚组ICP、PROM和产后出血的发生率较FET低,低体质量儿出生率较FET高(P<0.05),而PIH、前置胎盘、先兆子痫、胎盘早剥、母亲入ICU、死胎、新生儿死亡、新生儿住院、新生儿畸形、NICU以及早产的发生率两组间比较差异无统计学意义。结论辅助生殖助孕者的PIH、前置胎盘、ICP、产后出血、母亲入ICU、新生儿住院、低体质量儿、早产以及NICU的发生率较自然妊娠孕妇高。
Objective To retrospectively analyze the perinatal outcomes of 1 237 embryos transferred after embryo transfer in the Reproductive Medicine Center of Southwest Hospital. Methods Pregnant women with successful pregnancy underwent in vitro fertilization / intracytoplasmic sperm injection (IVF / ICSI) assisted fertilization at our center from January 2011 to July 2014 1 237 (711 cases of fresh embryo transfer cycle, 526 cases of frozen thawed embryo transfer (FET)) were enrolled as the control group (5040 pregnant women) Maternal perinatal conditions and neonatal birth outcomes. Results The average age of the pregnant group was (30.4 ± 4.2) years old, which was significantly higher than that of the control group (P0.05). The multiple birth rate and cesarean section rate in the assisted pregnancy group were significantly higher than those in the control group (P0.05) The average body weight of the newborn and the newborn were significantly lower than those of the control group (P <0.05). The levels of pregnancy-induced hypertension (PIH), placenta previa, intrahepatic cholestasis of pregnancy pregnancy, ICP), postpartum hemorrhage, mother into the ICU, neonatal hospitalization, low birth weight, premature birth and neonatal ICU (NICU) incidence was significantly higher than the control group (P <0.05) There was no significant difference between the two groups in the incidence of stripping, premature rupture of fetal membranes (PROM), preeclampsia, stillbirth, neonatal death and neonatal malformations. Compared with FET group, the incidences of ICP, PROM and postpartum hemorrhage in fresh embryo group were lower than those in FET group (P <0.05), while those in low birth weight group were higher than those in FET group (P <0.05). The incidences of PIH, placenta previa, preeclampsia, placental abruption, mother into ICU, stillbirth, neonatal death, neonatal hospitalization, neonatal malformation, NICU and preterm birth were significantly different between the two groups No statistical significance. Conclusion The incidences of PIH, placenta previa, ICP, postpartum hemorrhage, mother-to-child hospitalization, neonatal hospitalization, low birth weight, premature birth and NICU in assisted reproductive-assisted pregnancy are higher than those in spontaneous pregnant women.