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疏利琴, 黄锟, 严双琴, 徐叶清, 陶芳标. 辅助生殖技术对妊娠并发症和分娩结局影响出生队列研究[J]. 中国公共卫生, 2019, 35(1): 10-15. DOI: 10.11847/zgggws1118832
引用本文: 疏利琴, 黄锟, 严双琴, 徐叶清, 陶芳标. 辅助生殖技术对妊娠并发症和分娩结局影响出生队列研究[J]. 中国公共卫生, 2019, 35(1): 10-15. DOI: 10.11847/zgggws1118832
Li-qin SHU, Kun HUANG, Shuang-qin YAN, . Effects of assisted reproductive technology on pregnant complications and outcomes: a birth cohort study[J]. Chinese Journal of Public Health, 2019, 35(1): 10-15. DOI: 10.11847/zgggws1118832
Citation: Li-qin SHU, Kun HUANG, Shuang-qin YAN, . Effects of assisted reproductive technology on pregnant complications and outcomes: a birth cohort study[J]. Chinese Journal of Public Health, 2019, 35(1): 10-15. DOI: 10.11847/zgggws1118832

辅助生殖技术对妊娠并发症和分娩结局影响出生队列研究

Effects of assisted reproductive technology on pregnant complications and outcomes: a birth cohort study

  • 摘要:
      目的  探讨辅助生殖技术(ART)对妊娠并发症和分娩结局的影响。
      方法  依托中国安徽出生队列(C-ABCS)马鞍山现场,于2008年11月 — 2010年10月招募4 428名孕早期孕妇为研究对象,收集孕妇及其丈夫的人口学特征、孕期特有焦虑等基本信息,以妊娠期糖尿病、妊娠期肝内胆汁淤积症等妊娠并发症及婴儿孕周、出生体重、分娩方式等分娩结局作为结局变量,分析ART与妊娠并发症、分娩结局的病因关联。
      结果  ART在本研究的应用比例为3.70 %。ART组妊娠期糖尿病、妊娠期肝内胆汁淤积症的检出率分别为4.29 %和2.44 %,均高于自然妊娠组的1.53 %和0.56 %,2组差异有统计学意义(P < 0.05)。ART组剖宫产率为76.83 %,显著高于自然妊娠组的剖宫产率(64.94 %)。多因素logistic回归分析显示,ART组的孕妇发生妊娠期糖尿病、妊娠期肝内胆汁淤积症的风险较高,RR(95 % CI)分别为2.42(1.08~5.43)、4.40(1.51~12.82)。ART组孕妇选择剖宫产的风险高于自然妊娠组,RR(95 % CI)值为1.66(1.14~2.41)。
      结论  ART与孕妇发生妊娠期糖尿病和妊娠期肝内胆汁淤积症有关,ART孕妇更倾向于通过剖宫产终止妊娠。

     

    Abstract:
      Objective  To explore the effect of assisted reproductive technology (ART) on pregnancy complications and outcomes.
      Methods  The baseline data were from a birth cohort in Anhui province, China. A total of 4 428 pregnant women who received 1st prenatal care at Maternal and Child Health Center of Ma'anshan city from November 2008 to October 2010 were recruited. Basic demographic characteristics of the women and their husbands, special anxiety during pregnancy were collected with a questionnaire survey. Pregnant complications, such as gestational diabetes mellitus, intrahepatic cholestasis of pregnancy were recorded and information on delivery outcomes (gestational age, birth weight, delivery mode) were also collected.
      Results  The proportion of the women receiving ART was 3.7%. The detection rate of diabetes mellitus and intrahepatic cholestasis among the women with ART were 4.3% and 2.4%, respectively, and were significantly higher than those (1.5% and 0.6%) in the women without ART. Furthermore, the cesarean section rate was 76.8% among the women with ART and the rate was significantly higher than that (64.9%) in the women without ART. Multivariate logistic regression analysis demonstrated that the women with ART had higher risk of gestational diabetes mellitus (relative risk RR = 2.42, 95% confidence interval 95% CI: 1.08 – 5.43) and intrahepatic cholestasis of pregnancy (RR = 4.40, 95% CI: 1.51 – 12.82) and the women with ART were more likely to select cesarean section (RR = 1.66, 95% CI: 1.14 – 2.41) compared to the women without ART.
      Conclusion  Assisted reproductive technology is strongly associated with gestational diabetes mellitus and intrahepatic cholestasis of pregnancy. Pregnant women with ART are more likely to choose cesarean delivery.

     

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