CAJ | 학술논문

目的探讨不同辅助生殖技术妊娠分娩的新生儿出生缺陷的发生情况及影响因素.方法对1998年10月至2006年12月在郑州大学第一附属医院生殖医学中心接受体外受精(IVF)助孕[IVF、卵母细胞胞质内单精子注射(ICSI)、冻融胚胎移植(Thaw-ET)]妊娠的孕妇分娩的1271例新生儿(体外受精组)及同期接受人工授精妊娠的孕妇所分娩的269例新生儿(人工授精组)的临床资料进行分析,比较两组及不同辅助生殖技术后出生的新生儿情况、出生缺陷及出生缺陷受累系统.结果体外受精组中,IVF、ICSI、Thaw-ET后出生的低体重(LBW)儿分别为20.0%(134/671)、22.4%(92/410)、18.9%(36/190),也均高于人工授精组的11.5%(31/269),差异有统计学意义(P<0.05);多胎妊娠率分别为23.8%(160/671)、25.4%(104/410)、21.1%(40/190),均高于人工授精组的10.0%(27/269),差异也有统计学意义(P<0.05).ICSI后巨大儿发生率为3.9%(16/410),显著低于人工授精组的8.2%(22/269),两者比较,差异也有统计学意义(P<0.05);两组新生儿各系统出生缺陷比较,差异无统计学意义(P>0.05).结论不同体外受精助孕后多胎率明显升高,由此造成的相关风险也随之增加,但新生儿的出生缺陷并没有明显增加;减少多胎妊娠是保护出生新生儿健康的关键.
목적 탐토불동보조생식기술임신분면적신생인출생결함적발생정황급영향인소.방법 대1998년10월지2006년12월재정주대학제일부속의원생식의학중심접수체외수정(IVF)조잉[IVF、란모세포포질내단정자주사(ICSI)、동융배태이식(Thaw-ET)]임신적잉부분면적1271례신생인(체외수정조)급동기접수인공수정임신적잉부소분면적269례신생인(인공수정조)적림상자료진행분석,비교량조급불동보조생식기술후출생적신생인정황、출생결함급출생결함수루계통.결과 체외수정조중,IVF、ICSI、Thaw-ET후출생적저체중(LBW)인분별위20.0%(134/671)、22.4%(92/410)、18.9%(36/190),야균고우인공수정조적11.5%(31/269),차이유통계학의의(P<0.05);다태임신솔분별위23.8%(160/671)、25.4%(104/410)、21.1%(40/190),균고우인공수정조적10.0%(27/269),차이야유통계학의의(P<0.05).ICSI후거대인발생솔위3.9%(16/410),현저저우인공수정조적8.2%(22/269),량자비교,차이야유통계학의의(P<0.05);량조신생인각계통출생결함비교,차이무통계학의의(P>0.05).결론 불동체외수정조잉후다태솔명현승고,유차조성적상관풍험야수지증가,단신생인적출생결함병몰유명현증가;감소다태임신시보호출생신생인건강적관건.
Objective To investigate the incidence of and clinical factors influencing neonatal birth defects from different assisted reproductive technology. Methods Between October 1998 and December 2006,1271 newborns from mothers treated by in vitro fertilization techniques [ including in vitro fertilization (IVF), intracytoplasmic sperm injection (1CSI) and thaw embryo transfer (Thaw-ET) ] matched with 269 newborns from mothers treated by artificial insemination were enrolled in Reproductive Medicine Center in First Hospital Affiliated to Zhengzhou University. Their medical information was analyzed retrospectively to compared neonatal characteristics, the incidence of birth defect and anomalous organs involved between in vitro fertilization group and artificial insemination group. Results In group of in vitro fertilization, those newborns with low birth weight from IVF, ICSI and Thaw-ET were 20. 0% ( 134/671 ), 22. 4% (92/410), 18.9% (36/190)respectively, which were more than 11.5% (31/269) cases in group of artifical semination with statistical significance (P < 0. 05 ). The rates of multiple pregnancy of 23.8% ( 160/671 ), 25.4% (104/410) ,21.1% (40/190) in subgroup of 1VF, ICSI and Thaw-ET were significantly higher than 10. 0% ( 27/269 ) in group of artifical insemination( P < 0. 05 ). The rate of macrosomia in group of in vitro fertilization was significantly lower than that of artificial insemination group (3.9% vs 8. 2%, P <0.05). However, the incidence of birth defect involved in various organs did not show significant difference between two groups ( P>0.05 ). Conclusions The incidence of multiple pregnancy demonstrated obviously increasing trends born with various In Vitro Fertilization techniques, which pave the way to high risk pregnancy. However, the incidence of newborn birth defect was not increased significantly. Thus, to lower occurrence of multiple pregnancy was the key approach to obtain neonates health.