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足月体外受精新生儿的肺动脉压:一项横断面研究。

Pulmonary arterial pressure in at-term in vitro fertilization neonates: A cross-sectional study.

作者信息

Alipour Mohammad Reza, Pezeshkpour Zohreh, Namayandeh Seyedeh Mahdieh, Sarebanhassanabadi Mohammadtaghi

机构信息

Shahid Sadoughi University of Medical Sciences, Yazd Cardiovascular Research Center, Yazd, Iran.

出版信息

Turk J Obstet Gynecol. 2020 Jun;17(2):79-83. doi: 10.4274/tjod.galenos.2020.74152. Epub 2020 Jul 29.

Abstract

OBJECTIVE

Hormones consumption in women who conceive through in vitro fertilization (IVF) as well as embryonic manipulations have raised concerns regarding the neonates' health, including the possibility of pulmonary hypertension. This study, therefore, aimed to assess the pulmonary arterial pressure in at-term IVF neonates.

MATERIALS AND METHODS

This prospective cross-sectional study was conducted between March 2013 and October 2017 and compares 160 IVF neonates (group 1) with 160 naturally conceived neonates (group 2). The neonates in both groups were cesarean newborns, matched in terms of gestational and neonatal age. The neonates were three-seven days old, had a full-term gestational age of 37-39 weeks and 6 days, and a normal birth weight of 2500-4000 gr. The systolic pulmonary artery pressure (SPAP) was estimated using real-time echocardiography on the basis of peak flow velocity of tricuspid regurgitation jet.

RESULTS

A significant difference was observed in the mean SPAPs between the two groups (p<0.001). Although, the effect of gestational age on reducing SPAP was greater and statistically significant in group 1, the gradual decrease in the PAP after birth appeared to be slower in this group. Moreover, in both groups, the effect of gestational age on reducing SPAP was more convincing than that of the neonatal age. Further, in both groups, a significant reverse correlation was observed between the SPAP and the neonatal weight; however, it appeared to be markedly higher in group 1.

CONCLUSION

Our study renders IVF as being culpable in the incidence of pulmonary hypertension among neonates. Hence, to detect the likelihood of pulmonary arterial hypertension in IVF neonates, it is recommended to monitor their PAP during the neonatal period, and thereby facilitate them with the required treatment.

摘要

目的

通过体外受精(IVF)受孕的女性所使用的激素以及胚胎操作引发了对新生儿健康的担忧,包括患肺动脉高压的可能性。因此,本研究旨在评估足月IVF新生儿的肺动脉压。

材料与方法

本前瞻性横断面研究于2013年3月至2017年10月进行,将160例IVF新生儿(第1组)与160例自然受孕新生儿(第2组)进行比较。两组新生儿均为剖宫产出生,在孕周和新生儿年龄方面相匹配。新生儿出生3至7天,足月孕周为37 - 39周零6天,正常出生体重为2500 - 4000克。基于三尖瓣反流射流的峰值流速,使用实时超声心动图估计收缩期肺动脉压(SPAP)。

结果

两组之间的平均SPAP存在显著差异(p<0.001)。虽然,孕周对降低第1组SPAP的影响更大且具有统计学意义,但该组出生后肺动脉压的逐渐下降似乎较慢。此外,在两组中,孕周对降低SPAP的影响比新生儿年龄更具说服力。而且,在两组中,SPAP与新生儿体重之间均观察到显著的负相关;然而,第1组的负相关似乎明显更高。

结论

我们的研究表明IVF与新生儿肺动脉高压的发生率有关。因此,为检测IVF新生儿患肺动脉高压的可能性,建议在新生儿期监测其肺动脉压,从而为他们提供所需的治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ac7/7406899/560b45038eca/TJOG-17-79-g1.jpg

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