在使用体外受精的非常先进的母亲年龄分娩者中,早产的风险非常高
Rachel A Newman1, Mariam Naqvi1, Candace Levian1
1Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California.
American journal of perinatology
|August 21, 2023
概括
试管婴儿 (IVF) 在45岁及以上的女性中增加了早产风险. 这项研究发现,试管婴儿是非常先进的孕妇年龄患者早产的独立风险因素.
科学领域:
- 生殖医学 生殖医学
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 产科和妇科 产科和妇科
背景情况:
- 美国45岁及以上患者的出生率上升.
- 晚年母亲年龄和体外受精 (IVF) 独立地与母亲的不良结果有关.
- 关于晚年母亲年龄和试管婴儿对怀孕结果的联合影响的数据有限.
研究的目的:
- 为了确定通过试管婴儿受孕是否会增加45岁及以上的患者 (非常晚期的孕产妇年龄 - vAMA) 的早产风险.
- 为了比较通过试管婴儿怀孕的vAMA患者与没有试管婴儿怀孕的患者的PTB病率.
- 在这个队列中调查与试管婴儿相关的其他不良周产期结果.
主要方法:
- 对420名年龄≥45岁的孕妇进行了回顾性队列研究,她们在2014-2021年间分娩.
- 通过试管婴儿怀孕的患者和自然怀孕的患者之间的结果比较.
- 多变量逻辑回归分析调整了混因素,包括多胎妊娠,以评估试管婴儿对PTB (<37周妊娠) 的独立影响.
主要成果:
- 在vAMA队列中的试管婴儿患者更有可能是年长的,私人保险,无双胎,并有双胞胎怀孕.
- 在通过试管婴儿怀孕 (24.4%) 的vAMA患者中,PTB的发生率明显高于非试管婴儿怀孕 (8.4%) 的患者.
- 在调整后,试管婴儿是PTB的独立风险因素 (aOR = 4.3,95% CI: 1.7-10.4) 并与母体不良结果的复合相关 (aOR = 1.7,95% CI: 1.1-2.9).
结论:
- 通过试管婴儿受孕在非常晚的母亲年龄人口中显著与早产 (<37周) 的风险增加有关.
- 在vAMA患者中的试管婴儿与剖腹产和不良母亲结果的更高率有关.
- 在这个队列中,从试管婴儿怀孕中出生的新生儿的低出生体重和非常低出生体重率更高.
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