Liu Zhaodong, Yu Lu, Kang Xiaomeng, Zhang Yulong, Yan Jianying
Zhaodong Liu Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital College of Clinical Medicine, for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian Province 350001, P.R. China.
Lu Yu Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center Xiamen Hospital, Xiamen, Fujian Province 361027, P.R. China.
Pak J Med Sci. 2025 Jan;41(1):15-21. doi: 10.12669/pjms.41.1.10845.
BACKGROUND & OBJECTIVE: To assess the association of assisted reproductive technologies (ART) conception with postpartum hemorrhage (PPH) during the peripartum and postpartum periods.
Clinical records of 11,497 patients enrolled in Fujian Maternity and Child Health Hospital between March 2013 and December 2018 were retrospectively analyzed and divided into the ART group and the natural conception group based on the mode of conception. The incidence of PPH and blood loss at 30, 60, 90, and 120 minutes after delivery were compared.
Clinical records of 2527 patients with ART-derived and 78,970 patients with spontaneous pregnancies, who delivered at Fujian Maternity and Child Health Hospital between March 2013 and December 2018, were included. The incidence of PPH (2.53%vs 1.58%, P < 0.001) was greater in the ART group than in the natural conception group. ART was associated with significantly higher rates of PPH both in women who delivered vaginally and by cesarean section ( < 0.001). Similarly, blood loss during the delivery stage was greater in the ART group than in the naturally conceived group, regardless of the mode of delivery (P<0.001). Among women who delivered vaginally, blood loss was greater in the ART group at 30 minutes and 60 minutes after the delivery. However, blood loss at 90 and 120 minutes after the delivery was comparable in all groups, regardless of the mode of delivery.
The use of ART was associated with poorer maternal outcomes, including increased incidence of PPH and higher blood loss at 30 and 60 minutes after the delivery.
评估辅助生殖技术（ART）受孕与围产期及产后产后出血（PPH）之间的关联。
回顾性分析2013年3月至2018年12月在福建省妇幼保健院就诊的11497例患者的临床记录，根据受孕方式分为ART组和自然受孕组。比较产后30、60、90和120分钟时PPH的发生率和失血量。
纳入了2013年3月至2018年12月在福建省妇幼保健院分娩的2527例ART受孕患者和78970例自然受孕患者的临床记录。ART组PPH的发生率（2.53%对1.58%，P<0.001）高于自然受孕组。ART与阴道分娩和剖宫产分娩的妇女PPH发生率显著较高相关（<0.001）。同样，无论分娩方式如何，ART组分娩阶段的失血量均高于自然受孕组（P<0.001）。在阴道分娩的妇女中，ART组在分娩后30分钟和60分钟时的失血量更大。然而，无论分娩方式如何，所有组在分娩后90分钟和120分钟时的失血量相当。
使用ART与较差的孕产妇结局相关，包括PPH发生率增加以及分娩后30分钟和60分钟时失血量增加。
