摘要
目的探讨不同年龄段辅助生殖受孕孕妇母婴结局的影响。方法选取2014年至2018年在同济大学附属第一妇婴保健院分娩的110897例单胎产妇的临床资料,其中自然妊娠107330例,辅助生殖技术妊娠3567例,根据年龄划分为低龄组(年龄<35岁),高龄组(年龄≥35岁),回顾性分析不同年龄段辅助生殖孕妇妊娠合并症与并发症、以及严重产科并发症。结果随着年龄增加,辅助生殖受孕比例增加,其中高龄组人群的剖宫产率、妊娠期糖尿病(gestational diabetes mellitus, GDM)、早产以及胎儿宫内生长受限(fetal growth restriction, FGR)明显高于自然妊娠(P<0.05)。在高龄组和低龄组中,辅助生殖妊娠较自然妊娠产科合并症及并发症如GDM、子痫前期、剖宫产率、胎盘种植部位异常、产后出血等均明显上升,差异有统计学意义(P<0.05);且高龄辅助生殖发生率更高。辅助生殖妊娠较自然妊娠的产科严重并发症发生率更高,但对其进行多因素回归分析后结果显示差异无统计学意义(P>0.05)。结论辅助生殖妊娠率日渐上升,通过辅助生殖受孕的高龄孕产妇比例增高,其妊娠期合并症及并发症,以及危及孕产妇生命安全的严重产科并发症明显上升,提示这一部分人群为产科的重点监测对象,及早预防和干预,改善高龄辅助生殖孕妇的不良母婴结局。
Objective To investigate the maternal outcome after assisted reproductive technology(ART)in different age groups.Methods The clinical data of 110897 parturients who delivered in First Maternity and Infant Hospital Tongji University from 2014 to 2018 were enrolled,including 107330 cases of natural pregnancy and 3567 cases of assisted reproduction technology(ART)pregnancy.They were divided into two groups:the younger group(age<35),the older group(age≥35).The pregnancy complications and serious obstetric complications of different age groups were analyzed.Results With the increase of age,the proportion of assisted reproductive pregnancy increased.The rates of cesarean section,gestational diabetes mellitus(GDM),preterm delivery and intrauterine fetal growth restriction(FGR)in the older group of ART pregnancy were significantly higher than those in the natural pregnancy(P<0.05).The rates of pregnancy complications and serious obstetric complications in ART pregnancy were significantly higher than those in the natural pregnancy,including GDM,preeclampsia and cesarean section,placental implant site abnormality and postpartum hemorrhage(P<0.05),which were particularly higher in the older group of ART pregnancy.However,the multivariate regression analysis showed that there was no statistical difference in serious obstetric complications between ART pregnancy and natural pregnancy groups(P>0.05).Conclusion The pregnant complications and the serious obstetric complications are increased in ART pregnancy,particularly for older pregnant women,the early prevention and intervention can improve the maternal and infant outcomes of the elderly pregnant women with assisted reproduction.
作者
瞿翠翠
瞿晓娴
刘小华
QU Cui-cui;QU Xiao-xian;LIU Xiao-hua(Dept.of Obstetrics,Shanghai First Maternity and Infant Hospital,Tongji University School of Medicine,Shanghai 201204,China)
出处
《同济大学学报（医学版）》
CAS
2020年第3期314-318,共5页
Journal of Tongji University(Medical Science)
基金
上海市市级医疗卫生学科建设项目(2017ZZ02015)。
关键词
辅助生殖
高龄
妊娠合并症
严重产科并发症
产后出血
assisted reproduction technology
old age
pregnancy complications
sever mater morbidity
postpartum hemorrhage
