Jonas H A, Lumley J
Centre for the Study of Mothers' and Children's Health, Monash University, Carlton, Vic.
Med J Aust. 1993 May 17;158(10):659-63. doi: 10.5694/j.1326-5377.1993.tb121910.x.
To examine the perinatal characteristics of all higher order multiple births (133 sets of triplets and six sets of quadruplets) in the State of Victoria between 1982 and 1990. To compare the rising higher order multiple birth rates in Victoria with those in the other States of Australia, and to assess the impact of in-vitro fertilisation (IVF) and gamete intrafallopian transfer (GIFT) on these rising birth rates.
Retrospective review of all higher order multiple births registered in Victoria and other States of Australia between 1982 and 1990, and in particular those resulting from IVF and GIFT.
Victorian Perinatal Data Collection Unit, Australian Bureau of Statistics, National Perinatal Statistics Unit, data from Victorian IVF and GIFT units.
Higher order multiple birth rates and perinatal mortality rates.
The higher order multiple birth rates in Victoria rose from 3.5 per 10,000 in 1982 to 10.9 per 10,000 in 1990. The average perinatal mortality rates for the Victorian triplets and quadruplets born during this period were 10.8% and 25.0%, respectively. The rates of caesarean section were 70% and 83%; the proportions of deliveries in level III hospitals, 75% and 100%; and the mean maternal lengths of stay in hospital, 32 and 57 days, respectively. Endotracheal intubation was performed at birth in 18.5% of all infants. The proportions of triplet and quadruplet pregnancies in Victoria owing to IVF and GIFT rose during this period, reaching a peak of 42% in 1990. In the other States, the birth rates for higher order multiples increased at 1.8 times the rate observed for Victoria, with IVF and GIFT contributing to an estimated 43% of these conceptions between 1985 and 1989.
Restrictions on the numbers of embryos/oocytes transferred during IVF and GIFT should reduce the frequency of higher order multiple births.
研究1982年至1990年间维多利亚州所有高阶多胞胎（133组三胞胎和6组四胞胎）的围产期特征。比较维多利亚州不断上升的高阶多胞胎出生率与澳大利亚其他州的情况，并评估体外受精（IVF）和配子输卵管内移植（GIFT）对这些上升的出生率的影响。
对1982年至1990年间在维多利亚州和澳大利亚其他州登记的所有高阶多胞胎进行回顾性研究，特别是那些由IVF和GIFT导致的多胞胎。
维多利亚州围产期数据收集单位、澳大利亚统计局、国家围产期统计单位、维多利亚州IVF和GIFT单位的数据。
高阶多胞胎出生率和围产期死亡率。
维多利亚州的高阶多胞胎出生率从1982年的每10000例3.5例上升至1990年的每10000例10.9例。在此期间出生的维多利亚州三胞胎和四胞胎的平均围产期死亡率分别为10.8%和25.0%。剖宫产率分别为70%和83%；在三级医院分娩的比例分别为75%和100%；产妇平均住院天数分别为32天和57天。所有婴儿中18.5%在出生时进行了气管插管。在此期间，维多利亚州因IVF和GIFT导致的三胞胎和四胞胎妊娠比例上升，1990年达到42%的峰值。在其他州，高阶多胞胎的出生率以维多利亚州观察到的速度的1.8倍上升，1985年至1989年间，IVF和GIFT促成了这些妊娠的约43%。
限制IVF和GIFT过程中移植的胚胎/卵母细胞数量应能降低高阶多胞胎的发生率。
