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在接受人绝经期促性腺激素和醋酸甲羟孕酮治疗周期后出生儿童的新生儿结局和先天性畸形

Neonatal outcomes and congenital malformations in children born after human menopausal gonadotropin and medroxyprogesterone acetate treatment cycles.

作者信息

Zhang Jie, Mao Xiaoyan, Wang Yun, Chen Qiuju, Lu Xuefeng, Hong Qingqing, Kuang Yanping

机构信息

Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Rd, Shanghai, 200011, China.

出版信息

Arch Gynecol Obstet. 2017 Dec;296(6):1207-1217. doi: 10.1007/s00404-017-4537-z. Epub 2017 Sep 25.

Abstract

PURPOSE

To investigate neonatal outcomes and congenital malformations in children born after in vitro fertilization (IVF) and vitrified embryo transfer cycles using human menopausal gonadotrophin and medroxyprogesterone acetate (hMG + MPA) treatment.

METHODS

We performed a retrospective cohort study including 4596 live born babies. During January 2014-June 2016, children born after either hMG + MPA treatment, gonadotropin releasing hormone agonist short protocol, or mild ovarian stimulation were included. The main outcome measures were neonatal outcomes and congenital malformations.

RESULTS

Neonatal outcomes both for singletons and twins such as mean birth weight and length, gestational age, the frequency of preterm birth were comparable between groups. Rate of stillbirth and perinatal death were also similar. No significant differences were found in the overall incidence of congenital malformations between the three groups. Multivariable logistic regression indicated that hMG + MPA regimen did not significantly increase the risk of congenital malformations compared with short protocol and mild ovarian stimulation, with adjusted odds ratio of 1.22 [95% confidence interval (CI) 0.61-2.44] and 1.38 (CI 0.65-2.93), respectively, after adjusting for confounding factors.

CONCLUSIONS

Our data suggested that compared with conventional ovarian stimulations, hMG + MPA treatment neither compromised neonatal outcomes of IVF newborns, nor did increase the prevalence of congenital malformations.

摘要

目的

探讨使用人绝经期促性腺激素和醋酸甲羟孕酮(hMG + MPA)治疗的体外受精(IVF)和玻璃化胚胎移植周期后出生儿童的新生儿结局和先天性畸形。

方法

我们进行了一项回顾性队列研究,纳入4596例活产婴儿。在2014年1月至2016年6月期间,纳入接受hMG + MPA治疗、促性腺激素释放激素激动剂短方案或轻度卵巢刺激后出生的儿童。主要结局指标为新生儿结局和先天性畸形。

结果

单胎和双胎的新生儿结局,如平均出生体重和身长、胎龄、早产频率在各组之间具有可比性。死产率和围产期死亡率也相似。三组之间先天性畸形的总体发生率未发现显著差异。多变量逻辑回归表明,与短方案和轻度卵巢刺激相比,hMG + MPA方案在调整混杂因素后,先天性畸形风险未显著增加,调整后的优势比分别为1.22 [95%置信区间(CI)0.61 - 2.44]和1.38(CI 0.65 - 2.93)。

结论

我们的数据表明,与传统的卵巢刺激相比,hMG + MPA治疗既不影响IVF新生儿的新生儿结局,也不会增加先天性畸形的发生率。

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