辅助生殖技术后新生儿出生缺陷的临床调查分析
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摘要
目的探讨辅助生殖技术后新生儿出生缺陷的临床调查。方法选自2014年5月-2018年5月期间接受辅助生殖技术治疗且成功分娩的妇女900例,出生新生儿900例。分析辅助生殖技术后新生儿出生缺陷发生情况及危险因素。结果接受辅助生殖技术900例孕妇中,发生新生儿出生缺陷21例,发生率为2.33%。新生儿出生缺陷中,肢体畸形6例、先心病4例、神经管畸形3例、胆道闭锁2例、生殖器畸形2例、其他4例。经单因素分析表明,出生缺陷组与出生未缺陷组孕母年龄、文化程度、母亲吸烟、母亲饮酒和分娩方式比较无统计学差异(P>0.05);出生缺陷组妊娠期高血压多于出生未缺陷组,胎膜早破多于出生未缺陷组,羊水早破多于出生未缺陷组,具有统计学差异(P<0.05)。将上述单因素分析具有统计学差异的纳入多因素分析,妊娠期高血压、胎膜早破和羊水异常为影响新生儿出生缺陷危险因素。结论辅助生殖技术后新生儿出生缺陷中妊娠期高血压、胎膜早破和羊水异常为其危险因素。
Objective:To investigate the birth defects of newborns after assisted reproductive technology. Methods:From May 2014 to May-2018,900 women were successfully assisted with assisted reproductive technology and 900 neonates were born. Objective to analyze the incidence and risk factors of neonatal birth defects after assisted reproductive technology. Results:21 cases of birth defects occurred in 900 pregnant women who received assisted reproductive technology(2.33%). Among the birth defects,there were 6 cases of limb deformity,4 cases of congenital heart disease,3 cases of neural tube defects,2 cases of biliary atresia,2 cases of genital malformations,and 4 cases of other cases. The single factor analysis showed that there was no statistical difference between the birth defect group and the birth control group,the maternal age,the educational level,the mother′s smoking,the mother′s drinking and the mode of childbirth(P>0.05);the birth defect group was more hypertensive than the birth defect group,and the premature rupture of the membranes was more than the birth defect group,and the amniotic fluid early burst was more than the birth. There was statistical difference in the non defective group(P<0.05). The risk factors of neonatal birth defects were in pregnancy induced hypertension,premature rupture of membranes and abnormality of amniotic fluid. Conclusion:Hypertensive disorder complicating pregnancy,premature rupture of membranes and abnormal amniotic fluid are the risk factors for neonatal birth defects after assisted reproductive technology.
Objective:To investigate the birth defects of newborns after assisted reproductive technology. Methods:From May 2014 to May-2018,900 women were successfully assisted with assisted reproductive technology and 900 neonates were born. Objective to analyze the incidence and risk factors of neonatal birth defects after assisted reproductive technology. Results:21 cases of birth defects occurred in 900 pregnant women who received assisted reproductive technology(2.33%). Among the birth defects,there were 6 cases of limb deformity,4 cases of congenital heart disease,3 cases of neural tube defects,2 cases of biliary atresia,2 cases of genital malformations,and 4 cases of other cases. The single factor analysis showed that there was no statistical difference between the birth defect group and the birth control group,the maternal age,the educational level,the mother′s smoking,the mother′s drinking and the mode of childbirth(P>0.05);the birth defect group was more hypertensive than the birth defect group,and the premature rupture of the membranes was more than the birth defect group,and the amniotic fluid early burst was more than the birth. There was statistical difference in the non defective group(P<0.05). The risk factors of neonatal birth defects were in pregnancy induced hypertension,premature rupture of membranes and abnormality of amniotic fluid. Conclusion:Hypertensive disorder complicating pregnancy,premature rupture of membranes and abnormal amniotic fluid are the risk factors for neonatal birth defects after assisted reproductive technology.
引文
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[13]潘艳平,夏飞,茅彩萍,等.卵巢反应低下患者辅助生殖技术促排卵方案的对比分析[J].实用妇产科杂志,2017,33(5):352-357.
[14]王丽雅,钱叶青,金帆.借助辅助生殖技术出生子代的安全性研究进展[J].浙江大学学报:医学版,2017,46(3):279-284.
[15] Gasparri ML,Nirgianakis K,Taghavi K,et al. Placenta previa and placental abruption after assisted reproductive technology in patients with endometriosis:a systematic review and metaanalysis[J]. Arch Gynecol Obstet,2018,298(1):27-34.
[2]吴远桥,蒋群芳,金克勤.孕中期产前新生儿出生缺陷筛查的效果评价[J].浙江预防医学,2016,13(1):79-81.
[3]程萌,陈晗笑,许佳文,等.辅助生殖技术与子代神经系统疾病的相关性研究回顾[J].华西医学,2017,13(5):679-683.
[4]Henningsen AA,Bergh C,Skjaerven R,et al. Trends over time in congenital malformations in live-born children conceived after assisted reproductive technology[J]. Acta Obstet Gynecol Scand,2018,97(7):816.823.
[5]谭卫红,覃捷.促性腺激素释放激素激动剂在辅助生殖技术黄体支持中的应用进展[J].广西医科大学学报,2017,34(7):1107-1110.
[6]田晓勤,姜红.武汉市新生儿出生缺陷情况调查及相关危险因素分析[J].中国妇幼保健,2016,31(5):1021-1023.
[7]甄双平,吴亚玲,王慧敏.太原市389例新生儿出生缺陷的流行病学调查[J].中国妇幼保健,2017,32(19):4791-4795.
[8]葛辛,戴向楠,华天书,等.秦皇岛流动人口新生儿出生缺陷的疾病类型及其影响因素分析[J].广西医科大学学报,2017,34(10):1422-1424.
[9]窦倩,谭丽,马丽影,等.高龄不孕症患者辅助生殖技术中早期妊娠丢失的危险因素分析[J].现代妇产科进展,2017,26(5):380-381.
[10]张雪,刘凤杰,于莹,等.辅助生殖技术对孕产妇及其子代健康状况的影响[J].中国妇幼保健,2017,32(9):1969-1974.
[11]刘子源,王新利,韩彤妍,等.辅助生殖技术出生儿童的青春发育情况调查[J].中国当代儿科杂志,2017,19(6):646-651.
[12]张信贤,郝薇,王玮.先天性子宫畸形合并不孕患者行辅助生殖技术助孕研究进展[J].中国妇幼保健,2017,32(5):1093-1096.
[13]潘艳平,夏飞,茅彩萍,等.卵巢反应低下患者辅助生殖技术促排卵方案的对比分析[J].实用妇产科杂志,2017,33(5):352-357.
[14]王丽雅,钱叶青,金帆.借助辅助生殖技术出生子代的安全性研究进展[J].浙江大学学报:医学版,2017,46(3):279-284.
[15] Gasparri ML,Nirgianakis K,Taghavi K,et al. Placenta previa and placental abruption after assisted reproductive technology in patients with endometriosis:a systematic review and metaanalysis[J]. Arch Gynecol Obstet,2018,298(1):27-34.