Yanaihara Women's Clinic, 1-26-29 Ofuna, Kamakura, Kanagawa, 247-0056, Japan.
J Assist Reprod Genet. 2018 Mar;35(3):431-434. doi: 10.1007/s10815-017-1084-2. Epub 2017 Nov 14.
The purpose of this study was to compare the sizes of the placenta and umbilical cord in women with natural pregnancy versus those undergoing in vitro fertilization (IVF).
Overall, 1610 cases of uncomplicated single pregnancies with vaginal delivery at ≥ 37 weeks of gestation were included in this study. The patients were divided into two groups: natural pregnancy group (n = 1453) and IVF pregnancy not including intracytoplasmic sperm injection (ICSI) treatment (n = 157). The groups were compared in terms of gestational week, maternal age, parity, maternal weight gain, prepregnancy maternal BMI, infant weight at birth, infant head circumference, placental weight, cross section of the placenta, cross section of the umbilical cord, insertion site of the umbilical cord, and umbilical cord length. Stepwise selection and multivariate logistic regression were used for statistical analysis to correct the result as an independent factor.
There was no difference in the size of the placenta and umbilical cord between women with natural pregnancy and with IVF, but the incidence of velamentous insertion of the cord was significantly increased in women with IVF pregnancy (adjusted odd ratio [AOR] 1.72, 95% confidence interval [CI] 1.08-2.72, p = 0.026).
Although there is no difference in placental weight and cord size, velamentous insertion of the umbilical cord increases in IVF pregnancy and needs careful observation during the delivery process.
本研究旨在比较自然妊娠与体外受精(IVF)妇女的胎盘和脐带大小。
本研究共纳入 1610 例经阴道分娩且≥37 周的单纯单胎妊娠病例。患者分为两组:自然妊娠组(n=1453)和未行卵胞浆内单精子注射(ICSI)治疗的 IVF 妊娠组(n=157)。比较两组的孕周、产妇年龄、产次、产妇体重增加、孕前体重指数、新生儿出生体重、新生儿头围、胎盘重量、胎盘横截面积、脐带横截面积、脐带插入部位和脐带长度。采用逐步选择和多因素逻辑回归进行统计学分析,将结果校正为独立因素。
自然妊娠与 IVF 妊娠妇女的胎盘和脐带大小无差异,但 IVF 妊娠妇女的脐带帆状插入发生率明显增加(校正优势比[OR] 1.72,95%置信区间[CI] 1.08-2.72,p=0.026)。
尽管胎盘重量和脐带大小无差异,但 IVF 妊娠中脐带帆状插入增加,分娩过程中需要密切观察。