325例辅助受孕子代的出生情况

目的 了解辅助受孕子代与自然受孕子代的出生情况差异. 方法 本研究为前瞻性病例对照研究.2组人群均自母亲孕28周起入组登记,入组后由指定专业人员定期随访收集相关资料,所有子代出生时由专门的儿科医师做详细检查,并将相关出生情况登记入案.统计学分析采用x2检验. 结果 本研究最终获得673例新生儿资料,其中辅助受孕组325例,自然受孕组348例.比较2组新生儿的人口统计学特征,在母亲年龄构成、双亲受教育程度、家庭月收入、母亲本次分娩是否初产等方面差异无统计学意义(P＞0.05).辅助受孕组与自然受孕组新生儿中双胎儿(32.62％与3.45％,x2=98.88)、早产(30.46％与7.76％,x2=56.92)、低出生体重(32.31％与8.91％,x2=57.07)、入住新生儿重症监护病房(newborn intensive care unit,NICU)(27.38％与8.91％,x2=39.16)率和剖宫产娩出的比例(62.77％与21.55％,x2=117.64)比较,差异有统计学意义(P均＜0.01),但2组间出生缺陷的发生率差异无统计学意义(4.62％与2.59％,x2=2.01,P＞0.05).剔除所有双胎儿,仅比较单胎新生儿时,则显示2组在早产、低出生体重、出生缺陷、新生儿期人住NICU的发生率差异无统计学意义(P＞0.05),但辅助受孕组剖宫产娩出比例仍高于自然受孕组(61.18％与22.03％,x2=100.93,P＜0.01).另对体外受精-胚胎移植、卵母细胞浆单精子注射、冷冻胚胎移植3种不同辅助受孕方式的子代新生儿进行比较,各组间早产、低出生体重、出生缺陷、新生儿期入住NICU和剖宫产分娩比例的差异均无统计学意义(P＞0.05). 结论 辅助受孕技术本身对子代的新生情况无明显影响,高发的双胎及多胎妊娠是引起辅助受孕子代有更差的新生情况的主要原因.因此限制胚胎移植数量,降低双胎、多胎妊娠的发生率将成为保证辅助受孕子代生存质量的当务之急.

Neonatal outcomes of 325 neonates conceived with use of assisted reproductive technology

Objective To compare the neonatal outcomes between infants of assisted conception (AC) and natural conception (NC). Methods A prospective case-control study was conducted.Eligible mothers were invited to this study at 28 weeks of gestation and were followed up to delivery.All newborns were examined by pediatricians right after birth.Data including gestational age,birth weight,admission to neonatal intensive care unit (NICU),and presence of any major malformation were collected.Statistical analysis was performed with SPSS 13.0.Difference between two groups was compared by x2 test. Results Six hundred and seventy-three newborns were enrolled into this study,including 325 in AC group and 348 in NC group.There were no differences between the demographic characteristics of the two groups,including maternal age,parents' education,family income and proportion of primipara (P＞0.05).The incidences of twins (32.62％ vs 3.45％,x2 =98.88),preterm birth (30.46％ vs 7.76％,x2=56.92),low birth weight infant (32.31％ vs 8.91％,x2 =57.07)and admission to neonatal intensive care unit (27.38％ vs 8.91％,x2 =39.16) and proportion of cesarean birth (62.77％ vs 21.55％,x2=117.64) in AC group were significantly higher than in NC group (all P＜0.01),except for the incidence of birth defect (4.62％ vs 2.59％,x2=2.01,P＞ 0.05).However,no significant differences was found in the above items when only singletons were compared between the two groups (P＞0.05),except for the cesarean section rate (61.18％ vs 22.03％,x2 =100.93,P＜0.01).There were no difference in any of the above neonatal outcomes when different assisted reproductive technologies applied were compared (in vitro fertilization-embryo transfer,intracytoplasmic sperm injection and frozen embryo transfer) (P＞0.05). Conclusions Neonatal outcome after assisted conception is a bit worse than natural conception,which might mainly due to the large proportion of multiple pregnancy after assisted conception.In order to improve neonatal outcome after assisted conception,the number of embryos transferred should be limited.