Perinatal outcome of 12 021 singleton and 3108 twin births after non-IVF-assisted reproduction: a cohort study
Perinatal outcome of 12 021 singleton and 3108 twin births after non-IVF-assisted reproduction: a cohort study
复制标题
DOI：
10.1093/humrep/dei419
复制
发表时间：
2006-04-01
影响因子：
6.1
通讯作者：
Gyselaers, W
中科院分区：
文献类型：
--
作者：
Ombelet, W;Martens, G;Gyselaers, W
与自然受孕相比，辅助生殖技术（ART）导致的妊娠的围产期结局明显更差。我们调查了非IVF ART对围产期健康的可能风险。我们对两个暴露组进行了回顾性队列研究：控制性卵巢刺激（COS）后妊娠的研究组，有或没有人工授精（AI），以及自然受孕的对照组。我们使用了1993年1月至2003年12月期间比利时荷兰语区所有医院分娩的区域登记数据，以调查单胎和双胎妊娠围产期结局的差异。可选择单胎12021例，双胎3108例。自然受孕的受试者与母亲年龄、产次、胎儿性别和出生年份相匹配。主要观察指标为妊娠时间、出生体重、围产儿发病率和围产儿死亡率。我们的总体结果显示，COS/AI单胎早产（< 32和< 37周）、低出生体重和极低出生体重、转入新生儿重症监护室和大多数新生儿发病率参数的发生率显著较高。COS/AI导致的双胎妊娠显示新生儿死亡率、辅助通气和呼吸窘迫综合征的发生率增加。排除同性双胞胎后，COS/AI双胞胎妊娠极早产和极低出生体重的风险增加。总之，COS/AI单胎和双胎妊娠与自然受孕的儿童相比明显处于不利地位。
Perinatal outcome of pregnancies caused by assisted reproduction technique (ART) is substantially worse when compared with pregnancies following natural conception. We investigated the possible risks of non-IVF ART on perinatal health. We conducted a retrospective cohort study with two exposure groups: a study group of pregnancies after controlled ovarian stimulation (COS), with or without artificial insemination (AI), and a naturally conceived comparison group. We used the data from the regional registry of all hospital deliveries in the Dutch-speaking part of Belgium during the period from January 1993 until December 2003 to investigate differences in perinatal outcome of singleton and twin pregnancies. 12 021 singleton and 3108 twin births could be selected. Naturally conceived subjects were matched for maternal age, parity, fetal sex and year of birth. The main outcome measures were duration of pregnancy, birth weight, perinatal morbidity and perinatal mortality. Our overall results showed a significantly higher incidence of prematurity (< 32 and < 37 weeks), low and very low birth weight, transfer to the neonatal intensive care unit and most neonatal morbidity parameters for COS/AI singletons. Twin pregnancies resulting from COS/AI showed an increased rate of neonatal mortality, assisted ventilation and respiratory distress syndrome. After excluding same-sex twin sets, COS/AI twin pregnancies were at increased risk for extreme prematurity and very low birth weight. In conclusion, COS/AI singleton and twin pregnancies are significantly disadvantaged compared to naturally conceived children.