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体外受精与非体外受精妊娠的双卵双胎新生儿结局的选择。

Selected neonatal outcomes in dizygotic twins after IVF versus non-IVF pregnancies.

机构信息

Tornblad Institute, University of Lund, Lund, Sweden.

出版信息

BJOG. 2010 May;117(6):676-82. doi: 10.1111/j.1471-0528.2010.02517.x. Epub 2010 Feb 24.

Abstract

OBJECTIVE

To compare neonatal outcome among twins conceived after in vitro fertilisation (IVF) with that of spontaneously conceived twins.

DESIGN

Comparison of different-sex (dizygotic) twins born after IVF with non-IVF dizygotic twins.

SETTING

National health registers in Sweden.

POPULATION

All births in Sweden during the period 1982-2007.

METHODS

We studied gestational duration, lowest birthweight and birthweight difference in the twin pair, presence of one or two twins with a respiratory complication, and with jaundice in one or both twins. Risk estimates were calculated as odds ratios with adjustments for year of birth, maternal age, parity and smoking in pregnancy.

MAIN OUTCOME MEASURES

Gestational duration, birth weight, respiratory complications, jaundice.

RESULTS

We studied 1545 pairs of dizygotic twins born after IVF, and 8675 pairs of dizygotic twins where IVF was not known to have occurred. The risk for preterm delivery before 32 weeks of gestation was significantly increased among dizygotic twin pairs born after IVF compared with non-IVF dizygotic twin pairs. No significant difference in low birthweight or birthweight difference within twin pairs was seen. There was an increased occurrence of twin pairs with respiratory problems or jaundice, but only the latter diagnosis occurred in a statistically significant excess.

CONCLUSIONS

The study confirms recent findings that IVF is associated with an increased risk for some neonatal complications, not only among singletons but also among twins.

摘要

目的

比较体外受精(IVF)后受孕的双胞胎与自然受孕的双胞胎的新生儿结局。

设计

比较 IVF 后不同性别(双卵)双胞胎与非 IVF 双卵双胞胎的差异。

设置

瑞典国家健康登记处。

人群

1982 年至 2007 年期间在瑞典出生的所有婴儿。

方法

我们研究了 IVF 后双胎妊娠的孕程、最低出生体重和双胎体重差异、一对或两对双胞胎中是否有呼吸并发症,以及一对或两对双胞胎中是否有黄疸。风险估计值计算为比值比,调整了出生年份、母亲年龄、产次和妊娠期间吸烟状况。

主要观察指标

孕程、出生体重、呼吸并发症、黄疸。

结果

我们研究了 1545 对 IVF 后受孕的双卵双胞胎,以及 8675 对 IVF 情况未知的双卵双胞胎。与非 IVF 双卵双胞胎相比,IVF 后受孕的双卵双胞胎发生 32 周前早产的风险显著增加。低出生体重或双胎体重差异无显著差异。双胎呼吸问题或黄疸的发生率增加,但只有后者的诊断存在统计学意义上的差异。

结论

该研究证实了最近的发现,即 IVF 不仅与单胎妊娠,而且与双胎妊娠的某些新生儿并发症风险增加有关。

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