卵胞浆内单精子注射对母儿妊娠结局的影响

目的 探讨不同辅助生殖技术(in vitro fertilization/ intracytoplasmic sperm injection, IVF/ICSI)妊娠后单胎分娩的新生儿出生缺陷和母体并发症的发生情况及影响因素。方法 回顾性分析2010年1月至2013年6月在同济大学附属第一妇婴保健院生殖医学中心接受体外受精(in vitro fertilization, IVF)、卵胞浆内单精子注射(intracytoplasmic sperm injection, ICSI)新鲜胚胎移植后单胎分娩的新生儿的临床资料,比较IVF与卵子透明带侵入性操作后出生的母体并发症、新生儿一般情况、出生缺陷及出生缺陷受累系统。结果 共有1016例新生儿分娩,其中13例有出生缺陷,出生缺陷发生率1.28%,其中IVF组、ICSI组的出生缺陷率分别1.12%、1.67%,差异无统计学意义(P>0.05)。IVF组与ICSI组分娩的新生儿的体质量、孕周、性别无明显差异(P>0.05)；两组母体产科并发症发生率、早产率、低体质量儿率、极低出生体质量儿率、巨大儿发生率也无显著性差异(P>0.05)。ART子代发生出生缺陷可能与亲代低生育力、孕母年龄等有关。结论 不同助孕方式对母体产科并发症的发生、新生儿的一般情况及出生缺陷没有显著区别,有必要告知不孕患者辅助生殖技术的潜在风险。
Objective To investigate the pregnant outcomes following assisted reproductive techniques (ART) with in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Methods The medical information of offspring of pregnant women, who received ART (IVF or ICSI) in Shanghai First Maternity and Infant Hospital between January 2010 and June 2013, were retrospectively analyzed.The obstetric complications, neonatal condition, the incidence of birth defect and anomalous organs involved between IVF group and ICSI group were compared. Result The overall rate of birth defects among offspring by ART was 1.28% (13/1013), and 1.12% and 1.67% for IVF group and ICSI group respectively (P>0.05). There were no differences between IVF group and ICSI group in birth weight, gestational age and sex(P>0.05). There were no significant differences in rates of obstetric complications, low birth weight, very low birth weight, macrosomia and premature birth between two groups (P>0.05). Conclusion The obstetric complications, perinatal health and birth defects of IVF and ICSI singleton pregnancy are comparable