Umbilical cord anomalies are more frequent in twins after assisted reproduction
Umbilical cord anomalies are more frequent in twins after assisted reproduction
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DOI：
10.1093/humrep/dem191
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发表时间：
2007-10-01
影响因子：
6.1
通讯作者：
Temmerman, M.
中科院分区：
文献类型：
--
作者：
Delbaere, I.;Goetgeluk, S.;Temmerman, M.
背景：这项研究的目的是分析自然受孕的双胞胎和辅助生殖后出生的双胞胎脐带特征的差异。方法：1985-2004年间，东佛兰德斯双胞胎前瞻性调查(EFPTS)登记了4159对双胞胎。我们比较了2119个自然受孕的双卵双胞胎成员和2243个来自辅助生殖技术(ART)的双胞胎成员的脐带特征。数据根据双胞胎内部相关性、出生年份、母亲年龄、孕龄、产次、孩子性别和胎盘数量进行了调整。结果：双生子经不孕症治疗后，边缘脐带植入、帆状脐带植入和单脐动脉植入发生率较高(P<；0.001)。绒毛索插入的发生率与生殖技术的“侵袭性”成正比：自然受孕双胞胎3.6%，人工诱导排卵(AIO)双胞胎5%[优势比(OR)1.45；95%可信区间(CI)0.99-2.11]，IVF双胞胎7.4%(OR 1.49；95%CI 1.26-1.77)，ICSI后双胞胎10.4%(OR 1.31；95%CI 1.14-1.51)。AIO后SUA在双胞胎中的发生率最高：1.9%，而自然受孕的双胞胎为0.6%(OR 3.19；95%CI 1.66-6.11)。结论：抗逆转录病毒治疗后出生的双胞胎脐带较自然受孕双胞胎脐带更具病理特征。
Background: The objective of this study is to analyse differences in cord characteristics between naturally conceived twins and twins born after assisted reproduction. Methods: Between 1985 and 2004, the East Flanders Prospective Twin Survey (EFPTS) registered 4159 twin pairs. We compared cord characteristics between 2119 naturally conceived dizygotic (DZ) twin members and 2243 DZ twin members originating from assisted reproductive technologies (ART). Data were adjusted for intra-twin correlation, year of birth, maternal age, gestational age, parity, sex of the child and number of placentas. Results: Marginal cord insertion, velamentous cord insertion and single umbilical artery (SUA) occur more frequently in twins following infertility treatment (P < 0.001). The incidence of velamentous cord insertion increases proportionate with 'invasiveness' of reproductive techniques: 3.6% in naturally conceived twins versus 5% in twins after artificial induction of ovulation (AIO) [ odds ratio (OR) 1.45; 95% confidence interval (CI) 0.99-2.11], 7.4% in twins after IVF (OR 1.49; 95% CI 1.26-1.77) and 10.4% in twins after ICSI (OR 1.31; 95% CI 1.14-1.51). SUA has the highest incidence in twins after AIO: 1.9% compared with 0.6% in naturally conceived twins (OR 3.19; 95% CI 1.66-6.11). Conclusions: Umbilical cords of twins born after ART have more pathologic characteristics when compared with cords of naturally conceived twins.