本文選題：輔助生殖技術 + 自然受孕�。� 參考：《鄭州大學》2015年碩士論文

【摘要】：第一部分輔助生殖技術子代生長發(fā)育情況及影響因素目的:通過探討輔助生殖技術(Assisted reproductive technology,ART)子代與自然受孕(Natural conceived,NC)子代宮內生長發(fā)育情況及圍生期并發(fā)癥的發(fā)生情況,進而分析影響ART子代低出生體質量(Low birth weight,LBW)發(fā)生的相關影響因素。方法:選取自2012年8月-2014年8月在我院接受ART受孕并在我院住院娩出,胎齡≥28周的全部活產新生兒共287例為實驗組研究對象;隨機抽取同期于我院住院分娩的NC活產子代287例作為對照組。從生殖中心和產科提取所有接受輔助生殖技術治療的病案資料,符合納入標準的病例,用EXCEL軟件建立數(shù)據(jù)庫,記錄孕婦的姓名、編號、年齡、學歷、長期居住地、助孕方式、治療結局、胎兒數(shù)、分娩時間、分娩孕周、分娩方式、孕產次、流產史、月經(jīng)史、家族史、新生兒性別、出生體重、早孕期并發(fā)癥、分娩并發(fā)癥等可能的影響因素,計算機錄入資料,核實數(shù)據(jù)無誤后將數(shù)據(jù)導入SPSS17.0進行分析,定量資料分析采用t檢驗,定性資料分析采用PearsonХ2檢驗,檢驗水準α=0.05;數(shù)據(jù)服從正態(tài)性分布的用均數(shù)±標準差(x±s)表示,P0.05為差異有統(tǒng)計學意義。結果:1 ART組與NC組母親年齡、學歷、居住地、平素月經(jīng)情況、既往生產史及先兆流產情況的比較:ART組母親平均年齡較NC組目前年齡大、首次生產、學歷偏低、居住在農村地區(qū)、平素月經(jīng)不規(guī)律既及往有先兆流產史的比例較NC組高,相比差異有統(tǒng)計學意義。2 ART組與NC組子代出生體重、頭圍、身長及性別比例的比較:ART組平均頭圍、平均身長、平均體重均小于NC組,且差異均有統(tǒng)計學意義(P0.05);在子代性別比例上兩組差異無統(tǒng)計學意義(P0.05)。3去除多胎因素后兩組單胎子代的出生體重、頭圍、身長的比較結果:ART組單胎足月兒與單胎早產兒(胎齡無差異)的平均體重和平均身長均低于NC組,且差異有統(tǒng)計學意義(P0.05),但兩組間單胎的頭圍無明顯差異(P0.05)。4 ART組與NC組多胎妊娠、早產及剖宮產情況的比較:ART組多胎妊娠率(65.3%)、早產率(63.41%)和剖宮產率(90.94%)均高于NC組(分別為4.6%、24.39%、77.35%),差異均有統(tǒng)計學意義(P0.05);ART單胎早產的發(fā)病率(68.55%)同樣高于單胎NC組(25.95%),且差異有統(tǒng)計學意義(P0.05)。5 ART組與NC組孕期合并癥及產時合并癥的比較:ART組均高于NC組,且差異均有統(tǒng)計學意義(P0.05)。結論:1 ART組多胎妊娠、早產、剖宮產的發(fā)生率較NC組高,去除多胎因素后ART單胎早產的發(fā)生率仍高于NC組。2 ART組子代出生體重、頭圍、身長明顯低于NC組;去除多胎因素后,ART單胎足月兒和單胎早產兒的出生體重及身長仍低于相應的自然妊娠的單胎子代。3 ART組母親平素月經(jīng)不規(guī)律、既及往有先兆流產史、孕期合并癥及產時合并癥的發(fā)生率高于NC組。第二部分輔助生殖技術子代低出生體重危險因素研究目的:通過探討輔助生殖技術(Assisted reproductive technology,ART)子代低出生體質量(Low birth weight,LBW)發(fā)生的相關危險因素,為盡可能的減少ART子代低出生體質量的發(fā)生率提供較為科學的依據(jù)。方法:選取自2012年8月至2014年8月在我院接受ART受孕并在我院住院娩出,胎≥28周的全部活產新生兒共287例為實驗組研究對象;從生殖中心和產科提取所有接受輔助生殖技術治療的病案資料,符合納入標準的病例,用EXCEL軟件建立數(shù)據(jù)庫,記錄孕婦的姓名、編號、年齡、學歷、長期居住地、助孕方式、治療結局、胎兒數(shù)、分娩時間、分娩孕周、分娩方式、孕產次、流產史、月經(jīng)史、家族史、新生兒性別、出生體重、早孕期并發(fā)癥、分娩并發(fā)癥等可能的影響因素,計算機錄入資料,核實數(shù)據(jù)無誤后將數(shù)據(jù)導入SPSS17.0進行分析,單因素分析分析采用PearsonХ2檢驗,多因素采用Logistic回歸分析,P0.05為差異有統(tǒng)計學意義。結果:1單因素分析顯示:ART組孕母年齡、學歷、長期居住地、產時合并癥、孕期合并癥、早產及多胎與子代低出生體質量有關,這些因素會不同程度的影響子代的出生體重。2多因素Logistic回歸分析結果顯示:多胎、產時合并胎膜早破、產時合并子癇及早產與子代低出生體質量相關:多胎,OR=3.225,95%CI=1.673~6.215,P0.001;產時合并子癇,OR=3.845,95%CI=1.607~9.201,P=0.002,;產時合并胎膜早破,OR=2.294,95%CI=1.156~4.553,P=0.018;早產,OR=11.018,95%CI=5.044~24.066,P0.001。3輔助生殖技術類型在ART子代低出生體質量的發(fā)生率上無差別。結論:1多胎、早產、產時合并子癇、胎膜早破為ART子代低出生體質量的危險因素。2輔助生殖技術類型對子代出生體重的影響無差異。
[Abstract]:The first part auxiliary reproductive technology progeny growth and development and influence factors Objective: by exploring the subgeneration of Assisted reproductive technology (ART) and natural pregnancy (Natural conceived, NC) intrauterine growth and perinatal complications, and then analyzing the influence of the low birth weight of the ART progeny. (Low birth weight, LBW) related factors. Methods: 287 cases of all live births who received ART pregnancy in our hospital in August 2012 and hospitalized in our hospital, and all live births over 28 weeks of fetal age were selected as the subjects of the experimental group; 287 cases of NC live births at the same time in our hospital were randomly selected as the control group. Center and obstetrics extract all cases of medical records receiving assisted reproductive technology, in accordance with the standard cases, using EXCEL software to establish a database to record pregnant women's name, number, age, education, long-term residence, way of pregnancy, treatment outcome, fetal number, birth time, pregnancy week, delivery mode, pregnancy, abortion history, menstrual history, family history. Family history, newborn sex, birth weight, early pregnancy complications, childbirth complications and other possible factors, the computer entered the data, verified the data into the SPSS17.0 analysis, quantitative data analysis using t test, qualitative data analysis using Pearson 2 test, test level alpha =0.05; data obeys normal distribution The difference was statistically significant by means of mean mean standard deviation (x + s), and the difference was statistically significant. Results: the maternal age of 1 ART group and NC group, educational background, residence, normal menstruation, previous production history and threatened abortion were compared: the average age of the mother in group ART was larger than that of the NC group, the first production, the lower education, the rural areas, and the irregular menstruation The proportion of the law and the history of threatened abortion was higher than that of the NC group. The difference was statistically significant between the birth weight of the.2 ART group and the NC group, the head circumference, the body length and the sex ratio: the average head circumference of the ART group, the average body length, and the average weight were less than the NC group, and the difference was statistically significant (P0.05), and there was no statistical difference between the two groups in the sex ratio of the offspring. The comparative results of the birth weight, head circumference and body length of the two groups of the two groups of single fetuses after.3 removal were compared: the average weight and average length of the single fetal foot and single preterm infants (no difference in gestational age) in the ART group were lower than those in the NC group, and the difference was statistically significant (P0.05), but there was no significant difference in the head circumference of the single fetus between the two groups (P0.05).4 ART group and the other group (P0.05). The comparison of multiple pregnancy, preterm birth and cesarean section in group NC: the rate of multiple pregnancy in group ART (65.3%), the rate of premature delivery (63.41%) and cesarean section rate (90.94%) were higher than that of group NC (4.6%, 24.39%, 77.35%), the difference was statistically significant (P0.05), and the incidence of ART for single fetal preterm (68.55%) was also higher than that of the single fetus NC group (25.95%), and the difference was statistically significant (P0.0 5) the comparison between the.5 ART group and the NC group during pregnancy: the ART group was higher than the NC group, and the difference was statistically significant (P0.05). Conclusion: the incidence of multiple pregnancy, premature delivery and caesarean birth is higher than that of the NC group. The incidence of single fetal premature birth after the removal of multiple fetal factors is still higher than that of NC group.2 ART group birth weight, head circumference, body length is obvious The birth weight and length of ART single fetus and single fetal preterm infants were still lower than those of the single fetus generation.3 ART of the corresponding natural pregnancy after removal of multiple fetal factors. The incidence of threatened abortion, pregnancy complication and complication in pregnancy was higher than that of the NC group. The second part assisted reproductive technology subgeneration. Study on the risk factors of low birth weight: to provide a more scientific basis for reducing the incidence of low birth body mass in Assisted reproductive technology (ART) subgeneration of low birth body mass (Low birth weight, LBW), and to provide a scientific basis for reducing the rate of low birth weight of ART subgeneration. By August 2014, 287 cases of all live births who had received ART pregnancy in our hospital and were hospitalized in our hospital, and all the living births of all the births for more than 28 weeks were the subjects of the experimental group. All cases of medical records receiving assisted reproductive technology were extracted from the reproductive center and obstetrics, which were in accordance with the standard cases, and the database was set up with EXCEL software to record the names of pregnant women. Number, age, education, long-term residence, way of pregnancy, treatment outcome, fetus number, birth time, pregnancy week, mode of delivery, birth time, abortion history, menstrual history, family history, sex of the newborn, birth weight, pregnancy complications, childbirth complications and so on, computer input data, verify the data and import data into SPSS 17 analysis, single factor analysis and analysis of Pearson 2 test, multiple factors using Logistic regression analysis, P0.05 was statistically significant difference. Results: 1 single factor analysis showed that the ART group of pregnant women age, education, long-term residence, time of birth, pregnancy complications, preterm birth and multiple births are related to the low birth weight of the offspring, these factors will be .2 multiple factor Logistic regression analysis of the birth weight of the offspring of different degrees showed that multiple births, premature rupture of membranes, associated preeclampsia and premature birth were associated with low birth weight of the offspring: multiple births, OR=3.225,95%CI=1.673~6.215, P0.001; intrapartum eclampsia, OR=3.845,95%CI=1.607~9.201, P=0.002, and premature rupture of the membranes. OR=2.294,95%CI=1.156~4.553, P=0.018, preterm, OR=11.018,95%CI=5.044~24.066, and P0.001.3 assisted reproductive techniques have no difference in the incidence of low birth weight in the ART subgeneration. Conclusion: 1 multiple births, preterm birth, pregnancy combined with eclampsia, premature rupture of fetal membranes as a risk factor for low birth weight of ART offspring,.2 assisted reproductive technology type is born to the offspring. There is no difference in weight.
【學位授予單位】：鄭州大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R714.8

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