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冷冻胚胎受孕儿童的产科及围产期结局

Obstetric and perinatal outcome of children conceived from cryopreserved embryos.

作者信息

Wennerholm U B, Hamberger L, Nilsson L, Wennergren M, Wikland M, Bergh C

机构信息

Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Göteborg, Sweden.

出版信息

Hum Reprod. 1997 Aug;12(8):1819-25. doi: 10.1093/humrep/12.8.1819.

Abstract

The main purpose of this study was to evaluate the obstetric and neonatal outcome of children conceived from cryopreserved embryos. The medical records of 270 infants (163 singletons, 98 twins and nine triplets) were reviewed and compared with two control populations of children born after in-vitro fertilization (IVF) with fresh embryos and children born after spontaneous pregnancies. The controls were matched according to maternal age, parity, plurality and date of delivery. In the cryopreserved group the gestational age at delivery for singletons was 279 +/- 13 days with birthweight 3476 +/- 616 g; for twins gestational age was 257 +/- 19 days with birthweight 2574 +/- 560 g; for triplets gestational age was 228 +/- 3 days with birthweight 1752 +/- 183 g. The incidence of preterm birth (< 37 weeks gestation) was 5.6% for singletons, 44.9% for twins and 100% for triplets. Seven children had major malformations (2.7%) and perinatal mortality occurred in two children (8/1000). Gestational age at delivery, birthweight, the incidence of malformations and the perinatal mortality were comparable with the two control groups both for singletons and twins. Significantly more singletons in the cryopreserved group were delivered by Caesarean section compared with the spontaneous group. The number of infants with low Apgar score (< 7 at 5 min) and the number of infants admitted to neonatal intensive care units were similar in the cryopreserved and spontaneous groups. In conclusion, the cryopreservation process did not seem to adversely influence fetal development and no increased perinatal risk was found.

摘要

本研究的主要目的是评估经冷冻保存胚胎受孕的儿童的产科和新生儿结局。回顾了270名婴儿(163名单胎、98对双胞胎和9例三胞胎)的病历,并与两组对照组进行比较,一组是体外受精(IVF)后用新鲜胚胎出生的儿童,另一组是自然受孕出生的儿童。对照组根据产妇年龄、产次、胎儿数量和分娩日期进行匹配。在冷冻保存组中,单胎的分娩孕周为279±13天,出生体重为3476±616克;双胞胎的孕周为257±19天,出生体重为2574±560克;三胞胎的孕周为228±3天,出生体重为1752±183克。早产(孕周<37周)的发生率单胎为5.6%,双胞胎为44.9%,三胞胎为100%。7名儿童有严重畸形(2.7%),2名儿童发生围产期死亡(8/1000)。单胎和双胞胎的分娩孕周、出生体重、畸形发生率和围产期死亡率与两个对照组相当。与自然受孕组相比,冷冻保存组中单胎剖宫产分娩的比例明显更高。冷冻保存组和自然受孕组中Apgar评分低(5分钟时<7分)的婴儿数量以及入住新生儿重症监护病房的婴儿数量相似。总之,冷冻保存过程似乎并未对胎儿发育产生不利影响,也未发现围产期风险增加。

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