Kim Nari, Joo Eun Hui, Kim Seoyeon, Kim Taeho, Ahn Eun Hee, Jung Sang Hee, Ryu Hyun Mee, Lee Ji Yeon
Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.
Front Med (Lausanne). 2024 Jun 28;11:1407710. doi: 10.3389/fmed.2024.1407710. eCollection 2024.
The risks of invasive prenatal tests are reported in previous studies such as miscarriage, fetal anomalies, and bleeding. However, few compare short-term and long-term outcomes between invasive tests. This study aims to investigate obstetric, perinatal, and children's neurodevelopmental outcomes following chorionic villus sampling (CVS) or amniocentesis in singleton pregnancy.
This retrospective cohort study included healthy singleton pregnancies underwent transabdominal CVS (gestational age [GA] at 10-13 weeks) or amniocentesis (GA at 15-21 weeks) at a single medical center between 2012 and 2022. Only cases with normal genetic results were eligible. Short-term and long-term neurodevelopmental outcomes were evaluated.
The study included 200 CVS cases and 498 amniocentesis cases. No significant differences were found in body mass index, parities, previous preterm birth, conception method, and cervical length (CL) before an invasive test between the groups. Rates of preterm labor, preterm premature rupture of the membranes, preterm birth, neonatal survival, neonatal short-term morbidities, and long-term neurodevelopmental delay were similar. However, the CVS group had a higher rate of cervical cerclage due to short CL before 24 weeks (7.0%) compared to the amniocentesis group (2.4%). CVS markedly increased the risk of cervical cerclage due to short CL (adjusted odd ratio [aOR] = 3.17, 95%CI [1.23-8.12], = 0.016), after considering maternal characteristics.
Performing CVS resulted in a higher incidence of cerclage due to short cervix or cervical dilatation compared to amniocentesis in singleton pregnancies. This highlights the importance of cautious selection for CVS and the necessity of informing women about the associated risks beforehand.
先前的研究报告了侵入性产前检查的风险，如流产、胎儿畸形和出血。然而，很少有研究比较侵入性检查的短期和长期结果。本研究旨在调查单胎妊娠经绒毛取样（CVS）或羊膜穿刺术后的产科、围产期和儿童神经发育结局。
这项回顾性队列研究纳入了2012年至2022年在单一医疗中心进行经腹CVS（孕龄[GA]为10 - 13周）或羊膜穿刺术（GA为15 - 21周）的健康单胎妊娠。仅基因结果正常的病例符合条件。评估短期和长期神经发育结局。
该研究包括200例CVS病例和498例羊膜穿刺术病例。两组在侵入性检查前的体重指数、产次、既往早产史、受孕方式和宫颈长度（CL）方面未发现显著差异。早产、胎膜早破、早产、新生儿存活率、新生儿短期发病率和长期神经发育延迟的发生率相似。然而，与羊膜穿刺术组（2.4%）相比，CVS组在24周前因CL短而进行宫颈环扎的发生率更高（7.0%）。在考虑母体特征后，CVS显著增加了因CL短而进行宫颈环扎的风险（调整后的优势比[aOR]=3.17，95%置信区间[1.23 - 8.12]，P = 0.016）。
与单胎妊娠的羊膜穿刺术相比，进行CVS导致因宫颈短或宫颈扩张而进行环扎的发生率更高。这凸显了谨慎选择CVS的重要性以及事先告知女性相关风险的必要性。
