Reichelt J, Kyvernitakis I, Misselwitz B, Hadji P, Schmidt S, Kalder M
Gynäkologie und Geburtshilfe, Philipps-Universität Marburg, Marburg, Germany.
GQH, Geschäftsstelle Qualitätssicherung Hessen, Eschborn, Germany.
Z Geburtshilfe Neonatol. 2015 Feb;219(1):37-44. doi: 10.1055/s-0034-1390414. Epub 2015 Mar 3.
This study refers to population based data and investigates the development of the mode of delivery associated with infertility treatment over the last 23 years.
All 1 202,557 deliveries in Hesse, Germany, between 1990 and 2012 were assessed. 2.2% of the study population, 26,761, had a delivery subsequent to infertility treatment based on the Hessian Perinatal Registry (HEPE). An evaluation in this subgroup was performed investigating the associations between the mode of delivery and the gestational week and the mother's age.
A continuous and significant (p<0.01) increase of cesarean section (CS) rates subsequent to infertility treatment (1990: 41,3%; 2012: 55,9%) as well as a conversely also significant (p<0.01) reduction of vaginal operative and spontaneous deliveries associated with infertility treatment between 1990 and 2012 was found. Furthermore, the preterm delivery rate and the proportion of deliveries of parturients older than 35 years of age in association with infertility treatment raised over the last years. Rates of full-term deliveries and deliveries of women younger than 35 years remained stable during the observation period.
The rate of cesarean section is continuously rising over the last 23 years with regard to parturients subsequent to infertility treatment. The CS rate is significantly higher compared to women with a spontaneous pregnancy and in comparison to the data from 20 years ago. Most recently, the number of CS (51,2%) exceeded the number of vaginal deliveries (48,8%) in Hesse subsequent to infertility treatment for the first time.
本研究参考基于人群的数据，调查了过去23年中与不孕症治疗相关的分娩方式的发展情况。
对1990年至2012年间德国黑森州的1202557例分娩进行了评估。根据黑森州围产期登记处（HEPE）的数据，研究人群中有2.2%（26761例）在不孕症治疗后分娩。对该亚组进行了评估，调查了分娩方式与孕周和母亲年龄之间的关联。
发现不孕症治疗后剖宫产（CS）率持续显著上升（p<0.01）（1990年：41.3%；2012年：55.9%），1990年至2012年间与不孕症治疗相关的阴道手术分娩和自然分娩率则显著下降（p<0.01）。此外，近年来与不孕症治疗相关的早产率和35岁以上产妇的分娩比例有所上升。观察期内足月分娩率和35岁以下妇女的分娩率保持稳定。
在过去23年中，不孕症治疗后的产妇剖宫产率持续上升。与自然受孕的妇女相比，剖宫产率显著更高，与20年前的数据相比也是如此。最近，在黑森州，不孕症治疗后的剖宫产数量（51.2%）首次超过了阴道分娩数量（48.8%）。
