辅助生殖与异常出生体重的关联研究

Study on association of assisted reproductive technology with abnormalities in birth weight

摘要

目的 了解四川省2022年通过辅助生殖技术(ART)出生新生儿的异常出生体重发生率,以及主要的人口学特征、孕期健康和管理情况。方法 从四川省妇幼卫生信息平台导出2022年全年活产单胎数据,基于Logistic回归分析低出生体重儿、极低出生体重儿、巨大儿的高危因素,及其各自与辅助生殖的关联。结果 在四川省516115例单胎活产新生儿中,辅助生殖者低出生体重儿发生率为4.82%、极低出生体重儿发生率为0.39%、巨大儿发生率为5.37%.随着产妇年龄的增加,四川省2022年的辅助生殖率先增加后下降.彝族(0.34%)和藏族(0.24%)辅助生殖率均低于汉族(1.24%).辅助生殖者中初产妇、高血压者、纳入高危管理者的比例更高.在对产妇年龄、民族、产次、高血压、五色管理进行调整后,辅助生殖者的低出生体重儿发生风险(OR=1.172,95%CI:1.034~1.328)、巨大儿发生风险(OR=1.246,95%CI:1.107~1.401)均高于自然妊娠者(P<0.05);而辅助生殖者与自然妊娠者的极低出生体重儿发生风险(OR=1.213,95%CI:0.789~1.864)无统计学差异(P>0.05)。结论 通过ART出生的新生儿异常出生体重发生率更高,因此应进一步加强对高龄、初产、少数民族产妇的孕期保健,降低新生儿低出生体重、极低出生体重及巨大儿的发生率.

Abstract

Objective To investigate incidence of abnormalities in birth weight in infants born through assisted reproductive technique (ART) and their mothers' main demographic characteristics, as well as health and management during pregnancy in Sichuan province in 2022. Methods The data of all live single births in 2022 from Sichuan Maternal and Child Health Information System were derived. Logistic regression analysis was employed to explore high-risk factors for low birth weight infants, very low birth weight infants and macrosomia, and their respective correlations with ART. Results Among 516115 single live births in Sichuan province in the year 2022, the incidence of low birth weight infants born by mothers undergoing ART was 4.82%, the incidence of very low birth weight infants born by mothers undergoing ART was 0.39%, and the incidence of macrosomia born by mothers undergoing ART was 5.37%. The rate of assisted reproduction in Sichuan province initially rose and then declined with increase in maternal age in 2022. The rates of assisted reproduction in the women of Yi ethnic group (0.34%) and the women of Tibetan ethnic group (0.24%) were lower than that in the women of Han ethnic group (1.24%). In the ART recipients, proportions of primiparae, those with gestational hypertension and those women who were enrolled in high-risk management were higher. After adjusting for maternal age, parity, ethnicity, hypertension and five-color management, the probabilities of ART recipients giving birth to low birth weight infants (OR=1.172, 95%CI: 1.034-1.328) and macrosomia (OR=1.246, 95%CI: 1.107-1.401) remained significantly higher than those of naturally conceived women, while there was no statistically significant difference in probability of giving birth to very low birth weight infants (OR=1.213, 95%CI: 0.789-1.864). Conclusion The rate of abnormalities in birth weight in the newborns of mothers undergoing ART is higher. It is necessary to further enhance prenatal care for elderly, primiparous and minority mothers undergoing ART to reduce incidences of low birth weight, very low birth weight and macrosomia in the newborns.

关键词

低出生体重儿 / 极低出生体重儿 / 巨大儿 / 辅助生殖技术

Key words

low birth weight infant / very low birth weight infant / macrosomia / assisted reproductive technology

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基金资助

四川省科技计划资助项目(MZGC20230065)

四川省心理学会立项项目(SCSXLXH2023024)