International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
International Peace Maternity and Child Health Hospital of China Welfare Institution, Shanghai Jiao Tong University, Shanghai, China.
BMC Pregnancy Childbirth. 2023 May 20;23(1):369. doi: 10.1186/s12884-023-05619-0.
Chorioamnionitis (CAM) is a common risk factor for preterm births, resulting in several adverse outcomes. The association between infertility treatment and CAM is unclear. Therefore, this study examined the association between infertility treatment and CAM and described subsequent neonatal outcomes.
This population-based cohort study used data from the National Vital Statistics System Database. We included women who had a singleton live birth from January 1, 2016 to December 31, 2018. Women-infant pairs were stratified by infertility treatment, and the main outcome was a reported diagnosis of CAM in a checkbox format: clinical CAM or maternal temperature of > 38 °C. Multivariate logistic regression was used to examine the association between infertility treatment and CAM and the effect of infertility treatment on neonatal outcomes in women diagnosed with CAM.
The final sample comprised 10,900,495 woman-infant pairs, and 1.4% received infertility treatment. Compared with the natural conception group, women receiving infertility treatment had a significantly higher risk of CAM (adjusted odds ratio [aOR] 1.772 [95% confidence interval {CI}, 1.718-1.827]). Furthermore, newborns exposed to CAM had a higher risk of very low birth weight (VLBW) (aOR, 2.083 [95% CI, 1.664-2.606], P < .001), preterm birth (aOR, 1.497 [95% CI, 1.324-1.693]; P < .001), neonatal intensive care unit admission (aOR, 1.234 [95% CI, 1.156-1.317]; P < .001), and other adverse neonatal outcomes in the infertility treatment group compared with ones conceived naturally.
This study found that women who received infertility treatment had a higher risk of CAM. And CAM deteriorated neonatal outcomes in the infertility treatment group.
绒毛膜羊膜炎（CAM）是早产的常见危险因素，可导致多种不良后果。不孕治疗与 CAM 之间的关系尚不清楚。因此，本研究调查了不孕治疗与 CAM 之间的关系，并描述了随后的新生儿结局。
本基于人群的队列研究使用了国家生命统计系统数据库的数据。我们纳入了 2016 年 1 月 1 日至 2018 年 12 月 31 日期间单胎活产的女性。根据不孕治疗情况对母婴对进行分层，主要结局是在勾选框中报告的 CAM 诊断：临床 CAM 或母体体温>38°C。多变量逻辑回归用于检查不孕治疗与 CAM 之间的关系，以及在诊断为 CAM 的女性中，不孕治疗对新生儿结局的影响。
最终样本包括 10900495 对母婴，其中 1.4%接受了不孕治疗。与自然受孕组相比，接受不孕治疗的女性发生 CAM 的风险显著更高（校正优势比[aOR]1.772[95%可信区间{CI}，1.718-1.827]）。此外，暴露于 CAM 的新生儿发生极低出生体重（VLBW）（aOR，2.083[95%CI，1.664-2.606]，P<0.001）、早产（aOR，1.497[95%CI，1.324-1.693]；P<0.001）、新生儿重症监护病房（NICU）入住（aOR，1.234[95%CI，1.156-1.317]；P<0.001）和其他不良新生儿结局的风险更高，与自然受孕者相比。
本研究发现，接受不孕治疗的女性发生 CAM 的风险更高。并且，CAM 恶化了不孕治疗组的新生儿结局。
