辅助生育技术与自然受孕双胎妊娠结局的临床分析

目的探讨辅助生育技术与自然受孕两种不同方式双胎妊娠的临床结局。方法回顾性分析我院2005年-2008年7月分娩的143例辅助生育技术受孕双胎孕妇（ART组）和108例自然受孕双胎孕妇（对照组）的孕期合并症、分娩方式及围产儿儿结局。结果（1）ART组孕妇平均年龄（33．1±4．0）岁，对照组为（28．2±4．0）岁，两组比较差异有极显著性（P〈0．001）。（2）不良孕产史发生率ART组高于对照组（13．7％vs3．7％），差异有极显著性（P〈0．01）；初次产检孕周，ART组为（13．1±5．4）周，对照组为（17．4±6．9）周，ART组的孕期产检次数为（8．2±2．8）次，对照组为（6．7±3．1），均有极显著性差异（P≤0．001）。（3）ART组分娩孕周为（35．1±2．1）周，对照组为（34．4±2．4）周，ART组34周及以上分娩率高于对照组（P〈0．05）；妊娠期高血压疾病的发生率ART组低于对照组。（4）ART组新生儿平均出生体重（2394．3±38．04）g，对照组为（2184．9±53．20）g，差异有极显著性（P=0．001）。ART组极低出生体重儿发生率低于对照组。新生儿窒息、围产儿死亡率、一胎胎死宫内、先天性畸形的发生率，两组均无显著差异。结论ART助孕双胎孕妇更加重视孕期保健，分娩孕周延长，妊娠期高血压疾病的发生率较低，ART助孕组单卵双胎的比例较低．围产儿结局与自然爱孕双胎相似．

Outcome of twin pregnancies after assisted reproductive techniques and that conceived spontaneously.

Objective： To compare obstetrical and perinatal outcome of twin pregnancies after assisted reproductive techniques （ART） with that of twins conceived spontaneously. Method ： 251 cases of twin pregnancies including 143 cases after ART and 108 cases spontaneous conception delivered in our hospital from 2004 Jan. to 2008 Jul. were analyzed retrospectively. Results： Patients of the ART group were older and had more adverse outcome history than the control group and they pay more attention on the prenatal examination. There were significant differences in the gestational weeks and the incidence of premature delivery from the 34th week to the 37th week （ P 〈 0.05） between two groups. The incidence of PIH in the ART group was lower than the control. The incidence of single -egg twins is lower in ART group than the control group. Conclusion： In this comparative study, the obstetric and neonatal outcomes in ART group were similar, which indicate that ART might not represent a risk factor in term of adverse outcomes in twin pregnancy.