Venn A, Lumley J
Centre for the Study of Mothers' and Children's Health, Monash University, Carlton, Victoria.
Aust N Z J Obstet Gynaecol. 1993 Nov;33(4):379-84. doi: 10.1111/j.1479-828x.1993.tb02114.x.
Pregnancies following a period of infertility are often thought to be at increased risk of adverse outcomes. Between 1982-1990, 1465 births were reported to the Victorian Perinatal Data Collection Unit with a history of infertility. We present some characteristics of these births and compare them with all Victorian births in 1986 (n = 61,253) and Australian and New Zealand IVF and GIFT births 1979-1989 (n = 6,675). Women with a history of infertility were older than other Victorian women but younger than the IVF and GIFT group. Multiple births comprised 9% of the infertility group compared with 1.3% in the general Victorian population and 23.7% of IVF and GIFT births. The incidence of low birth-weight (18.6%) and very low birth-weight (4.2%) was higher than in other Victorian births (5.8% and 1.1% respectively) but lower than in IVF and GIFT births (34.6% and 8.9%). Perinatal mortality in the infertility group (33.4 per 1,000) was higher than in the general population (11.1 per 1,000) and similar to the IVF and GIFT group (34.9 per 1,000). The Caesarean section rate after infertility (41%) was more than double the rate in the rest of the Victorian population (16%), and showed a different pattern of indications. The relative risks of low and very low birth-weight, perinatal mortality and Caesarean delivery remained significantly increased for singletons after adjustment for maternal age and parity.
经历过一段时间不孕后怀孕的情况,通常被认为出现不良后果的风险会增加。1982年至1990年期间,有1465例有不孕史的分娩情况报告给了维多利亚州围产期数据收集部门。我们呈现了这些分娩情况的一些特征,并将它们与1986年维多利亚州的所有分娩情况(n = 61,253)以及1979年至1989年澳大利亚和新西兰的体外受精(IVF)及配子输卵管内移植(GIFT)分娩情况(n = 6,675)进行了比较。有不孕史的女性比其他维多利亚州女性年龄更大,但比IVF和GIFT组的女性年龄小。多胞胎在不孕组中占9%,而在维多利亚州普通人群中占1.3%,在IVF和GIFT分娩中占23.7%。低出生体重(18.6%)和极低出生体重(4.2%)的发生率高于其他维多利亚州分娩情况(分别为5.8%和1.1%),但低于IVF和GIFT分娩情况(34.6%和8.9%)。不孕组的围产期死亡率(每1000例中有33.4例)高于普通人群(每1000例中有11.1例),与IVF和GIFT组相似(每1000例中有34.9例)。不孕后的剖宫产率(41%)是维多利亚州其他人群剖宫产率(16%)的两倍多,且指征模式不同。在对产妇年龄和胎次进行调整后,单胎的低出生体重、极低出生体重、围产期死亡率和剖宫产的相对风险仍显著增加。