Adverse obstetric and perinatal outcomes of singleton pregnancies may be related to maternal factors associated with infertility rather than the type of assisted reproductive technology procedure used
Adverse obstetric and perinatal outcomes of singleton pregnancies may be related to maternal factors associated with infertility rather than the type of assisted reproductive technology procedure used
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DOI：
10.1016/j.fertnstert.2012.05.049
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发表时间：
2012-10-01
影响因子：
6.7
通讯作者：
Matsuda, Yoshio
中科院分区：
文献类型：
--
作者：
Hayashi, Masako;Nakai, Akihito;Matsuda, Yoshio
目的：比较不同类型的辅助生殖技术（ART）程序与自然受孕的单胎妊娠的产科和围产期结局。设计：回顾性队列研究。背景：日本妇产科学会围产期数据库。患者：总共 242,715 名单胎妊娠女性接受了研究。 作为基础队列进行检查。根据所使用的 ART 程序类型创建了三个研究组，即促排卵药物 (n = 4,111)、IUI (n = 2,351) 和 IVF-ET (n = 4,570)。为每个研究组随机选择针对多个母亲特征进行调整的对照。干预措施：无。主要结果指标：产科和围产期结局。结果：通过 ART 手术受孕的患者，无论采用何种 ART 方法，前置胎盘、早产和低出生体重儿的发生率增加，自然头位分娩的发生率降低。 结论：在单胎妊娠中，无论采用哪种 ART 手术，接受 ART 手术受孕的患者出现多种不良产科和围产期结局的风险都会增加。这些结果表明，与不孕相关的母体因素可能会导致不良后果，而不是 ART 手术本身。 （Fertil Steril (R) 2012；98:922-8。(C) 2012，美国生殖医学会。）
Objective: To compare obstetric and perinatal outcomes of singleton pregnancies conceived with different types of assisted reproductive technology (ART) procedures with those of naturally conceived pregnancies.Design: Retrospective cohort study.Setting: The perinatal database of the Japanese Society of Obstetrics and Gynecology.Patient(s): A total of 242,715 women with singleton pregnancies were examined as a base cohort. Three study groups were created according to the type of ART procedure used, namely ovulation stimulation medications (n = 4,111), IUI (n = 2,351), and IVF-ET (n = 4,570). Controls adjusted for multiple maternal characteristics were selected randomly for each study group.Intervention(s): None.Main Outcome Measure(s): Obstetric and perinatal outcomes.Result(s): Patients who conceived through the ART procedures were associated with an increased incidence of placenta previa, preterm delivery, and low birth weight infant and a decreased incidence of spontaneous cephalic delivery, regardless of the type of ART procedure.Conclusion(s): Among singleton pregnancies, patients conceived with ART procedures were at increased risk for several adverse obstetric and perinatal outcomes, regardless of the type of ART procedure used. These results suggest that maternal factors associated with infertility may contribute to the adverse outcomes rather than the ART procedures themselves. (Fertil Steril (R) 2012;98:922-8. (C) 2012 by American Society for Reproductive Medicine.)