供精人工授精1102例妊娠结局及影响因素分析

目的探讨供精人工授精(AID)助孕后的妊娠结局及其安全性。方法对2007年3月至2010年4月在广东省计划生育专科医院AID助孕成功妊娠的1102例1134个周期的临床资料进行总结。结果自然流产发生率为14.11%(160/1134),其中生化妊娠流产占20.00%(32/160),临床妊娠流产占80.00%(128/160)。随着年龄的增加,自然流产的发生率呈逐渐上升趋势(P=0.001)。异位妊娠发生率为1.32%(15/1134),妊娠中晚期引产发生率为0.88%(10/1134)。多胎发生率为2.73%(31/1134),其中三胎占12.90%(4/31),双胎占87.10%(27/31)。726例分娩,其中单胎占97.66%(709/726),双胎占2.34%(17/726),分娩方式中顺产自然分娩占42.15%(306/726),剖宫产占57.85%(420/726)。出生新生儿743个,男婴占50.87%(378/743),女婴占49.13%(365/743),男女性别比为104∶100。新生儿出生体重(3180±480)g,出生孕周(39.15±1.43)周。低出生体重儿占6.73%(50/743),巨大胎儿2.69%(20/743),早产儿4.17%(31/743)。出生缺陷发生率为1.74%(13/748)。结论女性年龄是AID妊娠重要影响因素。AID助孕在自然流产、异位妊娠、妊娠分娩、子代出生缺陷和健康状况等方面和自然受孕相似,是一项安全可靠的辅助生殖技术。

Analysis of the pregnancy outcome and influence factors of artificial insemination by donor in 1102 cases

Objective To explore the pregnancy outcome and safety of artificial insemination by donor (AID). Methods Consecutive cases of 1102 patients with 1134 pregnancies conceived by AID in Guangdong Provincial Family Planning Research Institute were recruited between March 2007 and April 2010. Results The abortion rate was 14.11% (160/1134), with 20.00% (32/160) of the biochemical pregnancies and 80.00% (128/160) of clinical pregnancies. The abortion rate significantly increased with the advancing female age (P=0.001). The ectopic pregnancy rate was 1.32% (15/1134), and the induction rate during middle and late pregnancy was 0.88% (10/1134). The multiple pregnancy rate was 2.73% (31/1134), with 12.90% (4/31) of triplets and 87.10% (27/31) of twins. 97.66% (709/726) was singleton, and 2.34% (17/726) was twins in 726 deliveries. Vaginal delivery rate and cesarean section rate were 42.15% (306/726) and 57.85% (420/726) respectively. Of 743 newborns, 50.87% (378/743) was male infant, and 49.13% (365/743) was female infant, with the sex ratio of 104∶100.The average birth weight of newborns was (3180±480)g, and the average gestational week was (39.15±1.43) weeks. 6.73% (50/743) was the low birth weight infant, and 2.69% (20/743) was fetal macrosomia, and 4.17% (31/743) was prematurity. The inborn defect rate was 1.74% (13/748). Conclusion Female age was an important influence factor of pregnancy conceived by AID.No differences of abortion, ectopic pregnancy, gestation, delivery and inborn defect were found between AID and the spontaneous pregnancies, therefore AID was a safe assisted reproductive technique.