论文部分内容阅读
目的分析北京市体外受精-胚胎移植(IVF-ET)助孕分娩构成情况及妊娠结局影响因素,探讨IVF-ET妊娠管理策略。方法采用北京市妇幼保健管理信息系统助产机构分娩上报数据,纳入2013年-2015年北京市户籍孕产妇分娩的368687例新生儿为研究对象,采用SPSS 16.0软件对IVF-ET分娩上报数据进行统计分析。结果 2013年-2015年北京市户籍产妇IVF-ET妊娠分娩数(分娩孕周≥28周的围生儿及<28周活产数)占围生儿出生总数的0.91%(3 342/368 687),其中2013年占0.58%(607/104 715),2014年占0.98%(1 330/135 622),2015年占1.09%(1 405/128 350)。IVF-ET妊娠分娩率呈逐年上升态势的同时,北京市IVF-ET分娩新生儿结局不断改善,新生儿足月分娩(孕周≥37周)占比由2013年的73.9%提高到2015年的81.7%,出生体质量≥2 500 g的新生儿分娩占比由2013年的74.50%提高至2015年的82.34%。分娩结局显示,IVF-ET妊娠孕妇较自然受孕孕妇妊娠期高血压疾病、早产、产后出血等妊娠合并症/并发症发生风险(OR值)在2.52~5.04之间。多元回归分析显示,IVF-ET孕妇妊娠风险增高与IVF-ET孕妇高龄、多胎妊娠以及IVF-ET受孕方式等因素相关,而IVF-ET妊娠分娩围生儿死亡率与自然受孕胎儿差异无显著性。结论随着生育政策的改变,高龄孕妇、辅助生殖技术妊娠还将进一步增加,辅助生殖技术多胎妊娠以及妊娠合并症/并发症比例随之增加,随着妊娠分娩选择的变化,规范IVF-ET诊疗,加强IVF-ET孕期管理是今后孕产期保健管理面临的一个新课题。
Objective To analyze the composition of pregnancy-assisted delivery (IVF-ET) and the influencing factors of pregnancy outcome in IVF-ET, and to explore the strategy of pregnancy management in IVF-ET. Methods The maternal and child health management information system of Beijing Maternal and Child Health Agency reported the data of birth delivery and included 368,687 newborn infants born from household registration in Beijing from 2013 to 2015. SPSS 16.0 software was used to count the reported data of IVF-ET delivery analysis. Results In 2013-2015, the number of pregnant and birthing IVF-ET of Beijing registered permanent residents (perinatal births ≥ 28 weeks and live births <28 weeks) accounted for 0.91% of the total number of perinatal neonates (3 342/368 687 ), Accounting for 0.58% (607/104 715) in 2013, 0.98% (1 330/135 622) in 2014 and 1.09% (1 405/128 350) in 2015. The rate of IVF-ET pregnancy delivery increased year by year at the same time, the outcome of newborns with IVF-ET delivery in Beijing continued to improve, and the proportion of full-term delivery (gestational age ≥37 weeks) in newborns increased from 73.9% in 2013 to The proportion of newborns with birth weight ≥ 2500 g increased from 74.50% in 2013 to 82.34% in 2015. The outcome of delivery showed that the risk of pregnancy complications / complications of IVF-ET pregnant women was 2.52-5.04 compared with that of pregnant women with gestational hypertension, premature birth and postpartum hemorrhage. Multivariate regression analysis showed that the increased risk of pregnancy in IVF-ET pregnant women was related to IVF-ET gestational age, multiple pregnancy and the IVF-ET method of pregnancy, while there was no significant difference in perinatal mortality between IVF-ET and spontaneous fertilization . Conclusion With the change of the fertility policy, pregnant women with advanced pregnancy and assisted reproductive technology will further increase the pregnancy, assisted reproductive technology multiple pregnancies and pregnancy complications / complications increased with the change of choice of pregnancy and childbirth, standardized IVF-ET treatment To strengthen the management of IVF-ET during pregnancy is a new topic for future maternal and child health management.