Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha City, Hunan 410078, China.
Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha City, Hunan 410078, China; Institute of Reproductive and Stem Cell Engineering, Central South University, Changsha City, Hunan 410078, China.
Reprod Biomed Online. 2017 Nov;35(5):583-591. doi: 10.1016/j.rbmo.2017.07.015. Epub 2017 Aug 3.
Unicornuate uteri are caused by non-development of one Müllerian duct. The objective of this study was to investigate pregnancy outcomes of singleton and/or twin pregnancies in women with unicornuate uterus after IVF-embryo transfer (IVF-ET). The study group comprised 238 patients with a unicornuate uterus and the control group 818 patients with normal uterus. Compared with pregnancies with normal uterine morphology, a unicornuate uterus was associated with an increased risk of early pregnancy loss [adjusted odds ratio (aOR) 1.88, 95% confidence interval (CI) 1.25-2.83; P = 0.002], premature delivery (aOR 2.11, 95% CI 1.45-3.07; P < 0.001), perinatal mortality (aOR 3.35, 95% CI 1.89-5.94; P < 0.001), low birthweight (LBW, aOR 1.43, 95% CI 1.04-1.79; P = 0.005) and very low birthweight (VLBW, aOR 2.58, 95% CI 1.53-4.34; P < 0.001). Additionally, significantly lower rates of term delivery (aOR 0.43, 95% CI 0.31-0.58; P < 0.001) and live birth (aOR 0.53, 95% CI 0.37-0.76; P < 0.001) were observed. These findings indicate that the presence of unicornuate uterus is associated with significantly increased risk of some adverse pregnancy outcomes compared with pregnancies with a normal uterus in women who undergo IVF-ET.
单角子宫是由于单侧缪勒管未发育引起的。本研究旨在探讨体外受精-胚胎移植(IVF-ET)后单角子宫患者单胎和/或双胎妊娠的妊娠结局。研究组包括 238 例单角子宫患者,对照组为 818 例正常子宫患者。与正常子宫形态的妊娠相比,单角子宫与早期妊娠丢失的风险增加相关[校正优势比(aOR)1.88,95%置信区间(CI)1.25-2.83;P=0.002]、早产(aOR 2.11,95%CI 1.45-3.07;P<0.001)、围产儿死亡率(aOR 3.35,95%CI 1.89-5.94;P<0.001)、低出生体重儿(LBW,aOR 1.43,95%CI 1.04-1.79;P=0.005)和极低出生体重儿(VLBW,aOR 2.58,95%CI 1.53-4.34;P<0.001)。此外,足月分娩率明显降低(aOR 0.43,95%CI 0.31-0.58;P<0.001)和活产率(aOR 0.53,95%CI 0.37-0.76;P<0.001)也较低。这些结果表明,与 IVF-ET 后正常子宫妊娠相比,单角子宫患者的一些不良妊娠结局风险显著增加。