First-trimester bleeding and twin pregnancy outcomes after in vitro fertilization
First-trimester bleeding and twin pregnancy outcomes after in vitro fertilization
复制标题
DOI：
10.1016/j.fertnstert.2016.03.027
复制
发表时间：
2016-07-01
影响因子：
6.7
通讯作者：
Kazer, Ralph. R.
中科院分区：
文献类型：
--
作者：
Eaton, Jennifer L.;Zhang, Xingqi;Kazer, Ralph. R.
目的：探讨体外受精（IVF）双胎妊娠早期出血与活产率的关系。设计：回顾性队列研究。背景：学术不孕实践。患者：1999年1月1日至2010年12月31日期间，从自体卵母细胞中提取的新鲜胚胎移植后，在妊娠早期超声检查中发现两个妊娠囊的妇女。干预:没有。主要结局指标：活产率。结果：65名妇女报告阴道出血，288名没有。两组的基线特征相似，除了妊娠早期阴道出血妇女的绒毛膜下血肿患病率增加（26.2%对1.7%）。出血妇女和无出血妇女的活产率相似（87.7% vs. 91.7%，校正优势比[OR] 0.73； 95%可信区间[CI]， 0.31-1.73）。288名妇女生下了活双胞胎。在分娩双胞胎的妇女中，妊娠早期出血的妇女至少有一个双胞胎低出生体重的风险增加（75.0%对59.7%）。在用逻辑回归控制了可能的混杂因素后，出血和低出生体重之间的关联仍然存在（校正OR 2.33, 95% CI, 1.14-4.74）。结论：无论是否存在妊娠早期出血，IVF双胎妊娠的活产率都很高。然而，在试管婴儿生育双胞胎的妇女中，妊娠早期出血与低出生体重的几率增加有关。(C) 2016年由美国生殖医学学会发布。
Objective: To examine the association between first-trimester bleeding and live-birth rates in twin pregnancies conceived with in vitro fertilization (IVF).Design: Retrospective cohort study.Setting: Academic infertility practice.Patient(s): Women with two gestational sacs on first- trimester ultrasound after transfer of fresh embryos derived from autologous oocytes between January 1, 1999, and December 31, 2010.Intervention(s): None.Main Outcome Measure(s): Live-birth rate.Result(s): Sixty-five women reported vaginal bleeding, and 288 did not. The baseline characteristics were similar between the two groups, except for an increased prevalence of subchorionic hematoma in women with first- trimester vaginal bleeding (26.2% vs. 1.7%). Live-birth rates were similar between women with bleeding and those with no bleeding (87.7% vs. 91.7%, adjusted odds ratio [OR] 0.73; 95% confidence interval [CI], 0.31-1.73). Two hundred eighty-eight women gave birth to live twins. Among the women who delivered twins, those with first-trimester bleeding had an increased risk of low birth weight of at least one twin (75.0% vs. 59.7%). The association between bleeding and low birth weight persisted after controlling for possible confounders with logistic regression (adjusted OR 2.33, 95% CI, 1.14-4.74).Conclusion(s): Live-birth rates are high in IVF twin gestations, regardless of the presence of first-trimester bleeding. Among women giving birth to IVF twins, however, first- trimester bleeding is associated with increased odds of low birth weight. (C) 2016 by American Society for Reproductive Medicine.