摘要
目的:探究既往剖宫产史对辅助生殖技术(ART)助孕后妊娠结局的影响。方法:采用病例对照研究,收集2021年至2024年在襄阳市第一人民医院接受ART助孕的212例孕妇临床资料。根据剖宫产史分为剖宫产史组(65例)和无剖宫产史组(147例)。使用单因素分析及多因素logistic回归分析比较两组妊娠结局。结果:与无剖宫产史组相比,剖宫产史组妊娠期糖尿病、肝内胆汁淤积症、前置胎盘、产后子宫收缩乏力和产褥期贫血的发生率显著增加,产褥期血红蛋白量明显减少(P<0.05);剖宫产史组新生儿的早产、新生儿呼吸窘迫、出生后转入新生儿重症监护室(NICU)、脐带异常和低体重儿发生率显著增加,出生体长明显减少(P<0.05)。多因素分析显示:剖宫产史增加了使用ART助孕后出现新生儿不良结局的风险(OR=5.51,95%Cl=2.26~14.51,P<0.001);孕妇年龄每增加1岁,新生儿不良结局风险降低9%(OR=0.91,95%CI=0.82~0.99);孕次3次者较2次者风险降低91%(OR=0.09,95%CI 0.03~0.27)(P均<0.05)。结论:既往剖宫产史是使用ART助孕后新生儿发生不良结局的危险因素,在临床中应该控制初次剖宫产率,增加有剖宫产史且使用ART助孕的孕妇孕检次数,预防不良妊娠的发生。
Objective To analyze the impact of previous cesarean section on pregnancy outcomes after assisted reproductive technology(ART).Methods A case-control study was conducted to collect clinical data from 212 pregnant women who underwent ART at Xiangyang No.1 People's Hospital from 2021 to 2024.Based on their cesarean sections,they were divided into a cesarean section group(65 cases)and a no cesarean section group(147 cases).One-way analysis of variance and multivariate logistic regression analysis were used to compare the pregnancy outcomes between the two groups.Results Compared to the no cesarean section group,the cesarean section group had an increased incidence of gestational diabetes mellitus,intrahepatic cholestasis,placenta previa,postpartum uterine atony,and puerperal anemia,along with a decrease in hemoglobin levels during the puerperium(P<0.05).In newborns of the cesarean section group,the rates of preterm birth,neonatal respiratory distress,postnatal transfer to the neonatal intensive care unit(NICU),umbilical cord abnormalities,and low birth weight were higher,and the birth length was reduced than those in the no cesarean section group(P<0.05).Multivariate analysis found that having cesarean section increased the risk of adverse neonatal outcomes after ART pregnancy(OR=5.51,95%CI=2.26-14.51,P<0.001).With maternal age increased by 1 year,there was a 9%reduction in the risk of adverse outcomes(OR=0.91,95%CI=0.82-0.99),while having three pregnancies as compared to two was associated with a 91%reduction in risk(OR=0.09,95%CI=0.03-0.27)(all P<0.05).Conclusion A history of cesarean section is a risk factor for adverse neonatal outcomes following ART pregnancy.Clinically,it is important to control the rate of first cesarean section and increase the frequency of prenatal check-ups for pregnant women with a history of cesarean section who are undergoing ART,to prevent adverse pregnancy outcomes.
作者
毛海琴
韦桂英
周媛
罗智略
仲超
史梦洁
段鹏
邓杰
MAO Hai-qin;WEI Gui-ying;ZHOU Yuan;LUO Zhi-lue;ZHONG Chao;SHI Meng-jie;DUAN Peng;DENG Jie(Department of Obstetrics and Gynecology,Xiangyang First People′s Hospital,Hubei Medical University,Xiangyang,Hubei 441000;Hubei Department of Obstetrics and Gynecology,Xiangyang First People′s Hospital Graduate Joint Training Base,School of Medicine,Wuhan University of Science and Technology,Wuhan,Hubei 430000;Department of Orthopedics,Xiangyang First People′s Hospital,Hubei Medical University,Xiangyang,Hubei 441000,China)
出处
《湖北医药学院学报》
2026年第1期46-51,共6页
Journal of Hubei University of Medicine
基金
湖北省自然科学基金创新发展联合基金重点项目(2022CFD010和2025AFD054)。
关键词
剖宫产史
辅助生殖技术
妊娠结局
危险因素
病例对照研究
Cesarean section
Assisted reproductive technology
Pregnancy outcomes
Risk factors
Case-control study
