辅助生殖技术后单胎妊娠的剖宫产风险。

Risk of cesarean section in singleton pregnancies after assisted reproductive techniques.

作者信息

Kozinszky Zoltán, Zádori Janos, Orvos Hajnalka, Katona Márta, Pál Attila, Kovács László

机构信息

Department of Obstetrics and Gynecology, University of Szeged, Center for Assisted Reproduction, Kaáli Institute, Department of Pediatrics, University of Szeged, Szeged, Hungary.

出版信息

J Reprod Med. 2003 Mar;48(3):160-4.

PMID:12698772

Abstract

OBJECTIVE

To evaluate the perinatal outcome of singleton pregnancies after assisted reproductive techniques in comparison with that in matched controls from spontaneous pregnancies.

STUDY DESIGN

A total of 11,776 deliveries from January 1, 1995, to May 31, 2001, were subjected to retrospective analysis. Data on 259 neonates from singleton pregnancies after ovulation induction (n = 85, 32.8%), intrauterine insemination (n = 17, 6.6%) or in vitro fertilization (n = 157, 60.6%) were evaluated. The pregnancy outcome was compared with that for controls (n = 518) matched for age, gravidity and parity after spontaneous pregnancies.

RESULTS

Cesarean section was significantly more frequent in the study group than in the control group (42.1% vs. 27.6%, P < .001, odds ratio [OR] 1.91, 95% confidence interval [CI] 1.39-2.61). The prevalence of preterm deliveries was not significantly higher (P = .40, OR 1.23, 95% CI .78-1.95) in the study group as compared with the controls (12.7% vs. 10.6%). There was no significant difference in intrauterine growth retardation between the two groups (9.3% vs. 6.2%, P = .14, OR 1.55, 95% CI .89-2.69).

CONCLUSION

Singleton pregnancies after assisted reproductive techniques are associated with an increased rate of cesarean section, whereas neonatal outcome is not influenced.

摘要

目的

评估经辅助生殖技术后的单胎妊娠围产期结局，并与自然妊娠的匹配对照组进行比较。

研究设计

对1995年1月1日至2001年5月31日期间的11776例分娩进行回顾性分析。评估了259例单胎妊娠新生儿的数据，这些妊娠分别为促排卵后妊娠（n = 85，32.8%）、宫腔内人工授精后妊娠（n = 17，6.6%）或体外受精后妊娠（n = 157，60.6%）。将妊娠结局与自然妊娠后年龄、孕次和产次相匹配的对照组（n = 518）进行比较。

结果

研究组剖宫产率显著高于对照组（42.1%对27.6%，P <.001，优势比[OR] 1.91，95%置信区间[CI] 1.39 - 2.61）。与对照组相比，研究组早产发生率无显著升高（P = 0.40，OR 1.23，95% CI 0.78 - 1.95）（12.7%对10.6%）。两组间胎儿宫内生长受限无显著差异（9.3%对6.2%，P = 0.14，OR 1.55，95% CI 0.89 - 2.69）。