摘要/Abstract

摘要： 目的 ·比较体外受精－胚胎移植术中单胚胎移植与双胚胎移植患者的妊娠结局及影响因素。方法 ·以 2011年 1月—2016年 6月于上海交通大学医学院附属第九人民医院体外受精－胚胎移植术后成功受孕患者为研究对象，对其随访至出现妊娠结局。根据胚胎移植数量，将患者分为单胚胎移植组和双胚胎移植组。采用 t检验、 χ2检验和多因素 Logistic回归分析比较 2组患者的妊娠结局，并分析不良结局的影响因素。结果 ·该研究共有 19 030例患者随访至妊娠结局（随访率 98.69%）。分组分析结果显示， 2组怀孕患者的妊娠结局构成比例不同（P0.000），在活胎数的构成上也存在显著差异（P0.000）。在新生儿出生体质量方面，单胚胎移植组患者分娩新生儿出生体质量高于双胚胎移植组（P0.000），其低出生体质量新生儿和足月低出生体质量新生儿的比例均低于双胚胎移植组（均 P0.000)。此外， 2组患者分娩新生儿中出生缺陷发生率间差异无统计学意义。多因素 Logistic回归分析的结果显示，调整了年龄、助孕指征及胚胎移植类型后，双胚胎移植组患者发生流产或引产的风险大于单胚胎移植组（OR0.88，P0.025）。结论 ·在体外受精－胚胎移植术中，双胚胎移植患者发生不良妊娠结局的风险高于单胚胎移植者。
关键词: 体外受精－胚胎移植术, 单胚胎移植, 双胚胎移植, 妊娠结局, 影响因素
Abstract:
Objective · To compare the pregnancy outcomes between the patients undergoing single embryo transfer and double embryo transferin vitro fertilization and embryo transfer, and analyze the influencing factors. Methods · Jan. 2011 to Jun. 2016, women who underwent single embryo transfer or double embryo transfer with in vitro fertilization and embryo transfer and successfully conceived in Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine were followed up to the pregnancy outcomes. According to the number of embryo transfer, the patients were divided into single embryo transfer group and double embryo transfer group. Univariate analysis (t test, Chi-square test) and multivariate Logistic regression analysis were used to compare the pregnancy outcomes between two groups, and analyze the influencing factors of adverse outcomes. Results · A total of 19 030 patients (98.69%) were followed up to the pregnancy outcomes. Stratified analysis showed that there were significant differences in the composition of pregnancy outcomes (P0.000) and the number of live births (P0.000) between two groups. For the neonatal birth quality, the infants bornthe patients with single embryo transfer had higher birth weights than those bornthe patients with double embryo transfer (P0.000), and the proportions of newborns with low birth weights and full-term newborns with low birth weights were higher among the patients with double embryo transfer compared to those with single embryo transfer (P0.000). In addition, there was no statistically significant difference in he incidence of birth defects between the infants bornthe patients with single embryo transfer and double embryo transfer. Multivariate Logistic regression analysis showed that the risk of abortion or labor induction among the patients with double embryo transfer was higher than those with single embryo transfer with age, infertility causes and embryo type adjusted (OR0.88, P0.025). Conclusion · The risk of adverse pregnancy outcomes is higher among the patients with double embryo transfer than those with single embryo transfer.
Key words: in vitro fertilization and embryo transfer (IVF-ET), single embryo transfer, double embryo transfer, pregnancy outcome, influencing factor


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