自然受孕与辅助生殖受孕妊娠期糖尿病患者围生期结局的回顾性队列研究
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摘要
目的比较不同受孕方式的妊娠期糖尿病患者围生期结局。方法选取2015年2月—2018年2月在本院分娩的的1 839例妊娠期糖尿病患者资料进行回顾性队列研究,其中辅助生殖组298例,自然受孕组1 541例,比较2组间母婴围生期结局。结果与自然受孕组相比,辅助生殖组孕妇年龄偏高,超重率偏低,差异有统计学差异(P<0.05)。辅助生殖组孕妇妊娠期高血压、严重子疒间前期、剖宫产以及早产发生率高于自然妊娠组,差异有统计学意义(P<0.05)。结论通过辅助生殖受孕的妊娠期糖尿病患者妊娠期高血压、严重子疒间前期、剖宫产以及早产等不良分娩结局风险增加。
Objective To explore the effect of different pregnancy methods on pregnancy outcome in patients with gestational diabetes mellitus. Methods The pregnancy outcome of 1,839 pregnant women(298 cases of assisted reproductive pregnancy, 1,541 of natural pregnancy) with gestational diabetes from February 2015 to February 2018 was retrospectively analyzed and compared.Results The maternal age of patients with gestational diabetes conceived by assisted reproduction was older but the rate of overweight lower, and the difference was statistically significant(P <0.05). The rate of hypertensive disorders of pregnancy,preeclampsia, cesarean section and preterm labor in the assisted reproductive conception group was higher than that in the natural pregnancy group(P <0.05). Conclusion The risk of pregnancy induced hypertension, severe preeclampsia, cesarean section and premature delivery increases among women with gestational diabetes mellitus by assisted reproductive technology.
Objective To explore the effect of different pregnancy methods on pregnancy outcome in patients with gestational diabetes mellitus. Methods The pregnancy outcome of 1,839 pregnant women(298 cases of assisted reproductive pregnancy, 1,541 of natural pregnancy) with gestational diabetes from February 2015 to February 2018 was retrospectively analyzed and compared.Results The maternal age of patients with gestational diabetes conceived by assisted reproduction was older but the rate of overweight lower, and the difference was statistically significant(P <0.05). The rate of hypertensive disorders of pregnancy,preeclampsia, cesarean section and preterm labor in the assisted reproductive conception group was higher than that in the natural pregnancy group(P <0.05). Conclusion The risk of pregnancy induced hypertension, severe preeclampsia, cesarean section and premature delivery increases among women with gestational diabetes mellitus by assisted reproductive technology.
引文
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[13]陈鹏,史琳,杨红梅,等.妊娠期高血压、子痫前期及子痫与孕前和孕期体质量及其他因素的相关性研究[J].实用妇产科杂志,2017,33(11):848-852.
[14]Wang Y A,Nikravan R,Smith H C,et al.Higher Prevalence of Gestational Diabetes Mellitus Following Assisted Reproduction Technology Treatment[J].Hum Reprod,2013,28(9):2554-2561.DOI:10.1093/humrep/det270.
[15]罗萌萌,于婉莹,崔静,等.辅助生殖过程中血糖控制情况对2型糖尿病患者妊娠结局的影响[J].中国煤炭工业医学杂志,2018,21(1):25-28.DOI:10.11723/mtgyyx1007-9564201801006.
[16]康卉娴,马彩虹,魏瑗,等.体外受精-胚胎移植与单胎妊娠早产风险关系研究[J].中国实用妇科与产科杂志,2017,33(6):609-612.DOI:10.19538/j.fk2017060114.
[17]Huang L S,Yen C H,Lee S H,et al.The Pregnancy Health and Birth Outcomes of Women Who Underwent Assisted Reproductive Technology:Results of a National Survey[J].Iran J Reprod Med,2011,9(4):269-276.
[2]Kushnir V A,Barad D H,Albertini D F,et al.Systematic Review of Worldwide Trends in Assisted Reproductive Technology 2004-2013[J].Reprod Biol Endocrinol,2017,15(1):6.DOI:10.1186/s12958-016-0225-2.
[3]Wang Y A,Nikravan R,Smith H C,et al.Higher Prevalence of Gestational Diabetes Mellitus Following Assisted Reproduction Technology Treatment[J].Human Reproduction,2013,28(9):2554-2561.DOI:10.1093/humrep/det270.
[4]American Diabetes Association.Classification and Diagnosis of Diabetes[J].Diabetes Care,2016,39(Suppl 1):S13-S22.DOI:10.2337/dc16-S005.
[5]Correa A,Bardenheier B,Elixhauser A,et al.Trends in Prevalence of Diabetes Among Delivery Hospitalizations,U-nited States,1993-2009[J].Matern Child Health J,2015,19(3):635-642.DOI:10.1007/s10995-014-1553-5.
[6]Coetzee A,Mason D,Hall D R,et al.Prevalence and Predictive Factors of Early Postpartum Diabetes among Women With Gestational Diabetes in a Single-center Cohort[J].Int J Gynaecol Obstet,2018,142(1):54-60.DOI:10.1002/ijgo.12494.
[7]Zhu W W,Yang H X,Wang C,et al.High Prevalence of Gestational Diabetes Mellitus in Beijing:Effect of Maternal Birth Weight and Other Risk Factors[J].Chin Med J(Engl),2017,130(9):1019-1025.DOI:10.4103/0366-6999.204930.
[8]王璇,陈廷美,于德纯,等.IADPSG标准下妊娠期糖尿病发病率及危险因素调查[J].实用医学杂志,2014,30(8):1318-1320.DOI:10.3969/j.issn.1006-5725.2014.08.045.
[9]谢幸.妇产科学[M].8版.北京:人民卫生出版社,2013.
[10]Stephansson O,Kieler H,Granath F,et al.Endometriosis,Assisted Reproduction Technology,and Risk of Adverse Pregnancy Outcome[J].Hum Reprod,2009,24(9):2341-2347.DOI:10.1093/humrep/dep186.
[11]Qin J,Liu X,Sheng X,et al.Assisted Reproductive Technology and the Risk of Pregnancy-related Complications and Adverse PregnancyOutcomes in Singleton Pregnancies:a Meta-analysis of Cohort Studies[J].Fertil Steril,2016,105(1):73-85.DOI:10.1016/j.fertnstert.2015.09.007.
[12]郝莹,臧彬.肥胖高血压患者血清瘦素与肾素-血管紧张素-醛固酮系统及胰岛素相关性分析[J].中国慢性病预防与控制,2008,16(3):275-278.DOI:10.3969/j.issn.1007-5410.2017.02.005.
[13]陈鹏,史琳,杨红梅,等.妊娠期高血压、子痫前期及子痫与孕前和孕期体质量及其他因素的相关性研究[J].实用妇产科杂志,2017,33(11):848-852.
[14]Wang Y A,Nikravan R,Smith H C,et al.Higher Prevalence of Gestational Diabetes Mellitus Following Assisted Reproduction Technology Treatment[J].Hum Reprod,2013,28(9):2554-2561.DOI:10.1093/humrep/det270.
[15]罗萌萌,于婉莹,崔静,等.辅助生殖过程中血糖控制情况对2型糖尿病患者妊娠结局的影响[J].中国煤炭工业医学杂志,2018,21(1):25-28.DOI:10.11723/mtgyyx1007-9564201801006.
[16]康卉娴,马彩虹,魏瑗,等.体外受精-胚胎移植与单胎妊娠早产风险关系研究[J].中国实用妇科与产科杂志,2017,33(6):609-612.DOI:10.19538/j.fk2017060114.
[17]Huang L S,Yen C H,Lee S H,et al.The Pregnancy Health and Birth Outcomes of Women Who Underwent Assisted Reproductive Technology:Results of a National Survey[J].Iran J Reprod Med,2011,9(4):269-276.