Aytoz A, De Catte L, Camus M, Bonduelle M, Van Assche E, Liebaers I, Van Steirteghem A, Devroey P
Centre for Reproductive Medicine, University Hospital and Medical School, Dutch-speaking Brussels Free University, Belgium.
Hum Reprod. 1998 Oct;13(1O):2958-61. doi: 10.1093/humrep/13.10.2958.
In this study we compared the pregnancy outcome of 576 pregnancies after prenatal diagnosis with that of 540 pregnancies without prenatal diagnosis in our microinjection programme. Amniocentesis was suggested for singleton pregnancies (n = 465) and chorionic villus sampling (CVS) was proposed for twin pregnancies (n = 111 pregnancies, 222 fetuses). A total of 365 patients with singleton pregnancies and 175 patients with twin pregnancies who did not undergo prenatal diagnosis were selected as controls. Compared with the controls, the odds ratios in the amniocentesis group for preterm delivery, low birthweight, very low birthweight and fetal loss were 0.97 [95% confidence interval (CI): 0.60-1.57], 1.27 (95% CI: 0.78-2.06), 1.57 (95% CI: 0.53-4.66) and 0.86 (95% CI: 0.32-2.37) respectively. Compared with the controls, the odds ratios in the CVS group for preterm delivery, low birthweight, very low birthweight and fetal loss were 0.89 (95% CI: 0.61-1.30), 1.03 (95% CI: 0.74-1.45), 0.79 (95% CI: 0.41-1.53) and 0.47 (95% CI: 0.17-1.30) respectively. We concluded that, in this series of intracytoplasmic sperm injection (ICSI) pregnancies, prenatal testing did not increase the preterm-delivery, the low-birthweight, or the very low-birthweight rates as compared with those of the controls. In the prenatal diagnosis group, the fetal loss rate was comparable to that of the control group. Larger prospective controlled studies are needed in order to inform patients reliably about the risks and the advantages of prenatal testing in ICSI pregnancies.
在本研究中,我们比较了在我们的显微注射程序中,576例经产前诊断的妊娠与540例未经产前诊断的妊娠的妊娠结局。对于单胎妊娠(n = 465)建议进行羊膜腔穿刺术,对于双胎妊娠(n = 111例妊娠,222个胎儿)建议进行绒毛取样(CVS)。总共选择了365名单胎妊娠且未接受产前诊断的患者和175名双胎妊娠且未接受产前诊断的患者作为对照。与对照组相比,羊膜腔穿刺术组早产、低出生体重、极低出生体重和胎儿丢失的比值比分别为0.97 [95%置信区间(CI):0.60 - 1.57]、1.27(95% CI:0.78 - 2.06)、1.57(95% CI:0.53 - 4.66)和0.86(95% CI:0.32 - 2.37)。与对照组相比,CVS组早产、低出生体重、极低出生体重和胎儿丢失的比值比分别为0.89(95% CI:0.61 - 1.30)、1.03(95% CI:0.74 - 1.45)、0.79(95% CI:0.41 - 1.53)和0.47(95% CI:0.17 - 1.30)。我们得出结论,在这一系列卵胞浆内单精子注射(ICSI)妊娠中,与对照组相比,产前检测并未增加早产、低出生体重或极低出生体重的发生率。在产前诊断组中,胎儿丢失率与对照组相当。需要进行更大规模的前瞻性对照研究,以便可靠地告知患者ICSI妊娠中产前检测的风险和益处。