辅助生殖技术中多胎妊娠减胎术后妊娠结局的比较

目的比较多胎妊娠减胎术后不同保留胎儿数对出生结局的影响。方法回顾性分析208例辅助生殖技术(ART)所获多胎妊娠行减胎术患者资料,其中157例为三胎减为双胎(减为双胎组),51例为多胎减为单胎(减为单胎组;包括三胎减为单胎25例,双胎减为单胎26例),另选同期ART双胎妊娠未行减胎术611例(未减双胎组)、单胎妊娠760例(未减单胎组)作为对照。比较各组新生儿出生结局及妊娠期并发症情况。结果多胎减胎术后子代出生缺陷未显著增加(P0.05);与单胎妊娠比较,双胎妊娠(包括减胎和未减胎)显著增加早产率、低出生体重儿率(P0.05);减胎术后双胎妊娠早产率、低出生体重儿率显著高于未减双胎者(分别为56.69%vs.45.34%、57.79%vs.44.77%,P0.05)。结论虽然ART后多胎妊娠减胎术并不增加子代的出生缺陷,但是仍然应该控制多胎妊娠、减少减胎术的干预,提高ART助孕的安全性。

Comparison of pregnancy outcomes of multifetal pregnancy reduction in assisted reproductive technique

Objective:To compare the birth outcome in different number of retained fetuses after fetal reduction.Methods:A retrospective analysis was performed on 208 patients with multiple pregnancies who accepted fetal reduction in ART treatment.Among them,157 patients with triplet pregnancies were reduced to twins,and 51 patients including 25 triplet pregnancies and 26 twins pregnancies were reduced to singleton.Another 611 patients with twins pregnancy and without reduction,and 760 singleton pregnancy without reduction were recruited as control groups.The neonatal birth outcomes and complications during pregnancy were compared among the groups.Results:The incidence of newborn birth defect was not increased significantly after fetal reduction (P＞0.05).The preterm birth rate and low birth weight rate were significantly increased in twins pregnancy (with or without reduction) (P＜ 0.05).Comparing to twins pregnancy without reduction group,the preterm birth rate (56.69％ vs.45.34％) and low birth weight rate (57.79％ vs.44.77％) were significantly higher in reduced twins group (P＜0.05).Conclusions:Although the incidence of newborn birth defect was not increased after fetal reduction in ART,the multiple pregnancy and the intervention of fetal reduction should be controlled in order to improving the safety of ART.