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目的探讨体外受精-胚胎移植(IVF-ET)与单胎妊娠早产风险的关系。方法选取2012年1月至2013年1月行IVF-ET并于北京大学第三医院助孕且分娩的单胎妊娠孕妇563例为研究组,其中女性因素不孕组(单纯女性因素或合并双方因素)369例、单纯男性因素不孕组150例,44例不明原因不孕;按年龄、孕产次配对同一时间段自然单胎妊娠的1126例孕妇为对照组,分析两组产科结局。结果研究组早产率显著高于对照组(11.90%vs.6.93%,P<0.05),妊娠期糖尿病、胎膜早破、前置胎盘、产后出血的发生率显著高于对照组,新生儿出生孕周显著低于对照组[(38.64±2.16)周vs.(39.12±1.73)周,P<0.05],低出生体重发生率显著高于对照组(8.34%vs.4.35%,P<0.05)。女性因素不孕组早产率显著高于单纯男性因素不孕组及对照组(12.74%vs.6.67%vs.6.93%,P<0.05);胎膜早破、产后出血发生率显著高于单纯男性因素不孕组(28.7%vs.11.33%,14.63%vs.6.67%,P<0.05),妊娠期糖尿病、胎盘早破、前置胎盘、产后出血发生率显著高于对照组(P<0.05);女性因素不孕组新生儿出生孕周显著低于单纯男性因素不孕组及对照组[(38.51±2.15)周vs.(38.97±1.85)周vs.(38.64±2.16)周,P<0.05)],低出生体重发生率显著高于对照组(8.94%vs.4.35%,P<0.05)。结论体外受精-胚胎移植患者单胎妊娠早产发生率增加,可能与引起女性不孕因素相关疾病及女性因素不孕妇女妊娠期并发症发生率增加相关。
Objective To investigate the relationship between IVF-ET and the risk of preterm birth in singleton pregnancy. Methods A total of 563 singleton pregnant women who underwent IVF-ET from January 2012 to January 2013 in Peking University Third Hospital were enrolled in this study. Female infertility group (female only or both parties Factors) 369 cases, simple male infertility group 150 cases, 44 cases of unexplained infertility; according to age, pregnancy and childbirth with the same time period of natural singleton pregnancy in 1126 pregnant women as the control group, analysis of the two obstetric outcomes. Results The preterm birth rate in the study group was significantly higher than that in the control group (11.90% vs.6.93%, P <0.05). The incidence of gestational diabetes mellitus, premature rupture of membranes, placenta previa and postpartum hemorrhage were significantly higher in the study group than those in the control group Gestational age was significantly lower than the control group [(38.64 ± 2.16) weeks vs. (39.12 ± 1.73) weeks, P <0.05], the incidence of low birth weight was significantly higher than that of the control group (8.34% vs.4.35%, P <0.05) . The rate of preterm birth in infertile women was significantly higher than that in infertile women and controls (12.74% vs.6.67% vs.6.93%, P <0.05). The rates of premature rupture of membranes and postpartum hemorrhage were significantly higher than those in men (28.7% vs.11.33%, 14.63% vs.6.67%, P <0.05). The incidence of gestational diabetes mellitus, premature placenta previa, placenta previa and postpartum hemorrhage were significantly higher than those in control group (P <0.05) (38.51 ± 2.15) weeks vs. (38.97 ± 1.85) weeks vs. (38.64 ± 2.16) weeks vs (38.64 ± 2.16) weeks, P <0.05, respectively. The gestational age at birth was significantly lower in female infertility group than in male infertility group and control group )], The incidence of low birth weight was significantly higher than that of the control group (8.94% vs.4.35%, P <0.05). Conclusions The incidence of singleton pregnancy preterm birth in patients undergoing in vitro fertilization and embryo transfer increased, which may be related to the incidence of infertility-related diseases and female infertility.