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体外受精妊娠后出生体重<1500g 的早产儿与自然受孕早产儿的围产结局比较。

Perinatal outcome of preterm infants <1500 g after IVF pregnancies compared with natural conception.

机构信息

Division of General Pediatrics and Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Austria.

出版信息

Arch Dis Child Fetal Neonatal Ed. 2010 May;95(3):F225-9. doi: 10.1136/adc.2009.165761.

Abstract

OBJECTIVE

In vitro fertilisation (IVF) pregnancies are at increased risk for adverse perinatal outcome including very low birth weight infants. The purpose of this study was to find out whether the perinatal outcome of preterm infants <1500 g after IVF is different from those in naturally conceived pregnancies.

PATIENTS AND METHODS

This retrospective cohort study included preterm infants <1500 g born between 1999 and 2007 in a tertiary perinatal referral centre. All analyses were made separately for singletons and multiples, divided into infants <1000 g and 1000-1499 g. The primary study outcomes were infant mortality, short term pulmonary morbidity and cerebral morbidity. The secondary study outcomes were small for gestational age, Apgar score at 5 min, the results of the first venous blood gas analysis of the preterm infant, and the first mean arterial blood pressure after neonatal intensive care unit admission. Logistic regression analysis was done to assess the impact of IVF compared to other maternal and infant factors.

RESULTS

1423 patients (195 IVF and 1228 non-IVF patients) were included in this study. The incidence of preterm labour was significantly higher in multiples after IVF than in spontaneously conceived multiples. In the IVF group, there were significantly more multiples. Mortality, pulmonary morbidity and cerebral morbidity did not differ among patients after IVF and naturally conceived patients. Also, there were no significant differences for the secondary outcomes, except for a significantly higher initial pH value in multiples after IVF between 1000-1499 g.

CONCLUSION

IVF treatment was not associated with adverse outcome in very low birth weight infants. IVF, preterm birth, VLBW, singletons, multiples, outcome.

摘要

目的

体外受精(IVF)妊娠的围产期结局不良风险增加,包括极低出生体重儿。本研究的目的是了解体外受精后<1500g 的早产儿的围产期结局是否与自然受孕妊娠不同。

方法

本回顾性队列研究纳入了 1999 年至 2007 年在一家三级围产期转诊中心出生的<1500g 的早产儿。所有分析均针对单胎和多胎分别进行,分为<1000g 和 1000-1499g 的婴儿。主要研究结局为婴儿死亡率、短期肺部发病率和脑发病率。次要研究结局为小于胎龄儿、5 分钟时的 Apgar 评分、早产儿第一次静脉血气分析结果以及新生儿重症监护病房入院后第一次平均动脉血压。采用逻辑回归分析评估 IVF 与其他母婴因素的影响。

结果

本研究纳入了 1423 名患者(195 名 IVF 患者和 1228 名非 IVF 患者)。IVF 后多胎的早产发生率明显高于自然受孕的多胎。在 IVF 组中,多胎的比例明显更高。IVF 组和自然受孕组的死亡率、肺部发病率和脑发病率无差异。此外,除了 IVF 后 1000-1499g 的多胎初始 pH 值明显较高外,其他次要结局也无显著差异。

结论

IVF 治疗与极低出生体重儿的不良结局无关。IVF、早产、极低出生体重、单胎、多胎、结局。

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