中国实用妇科与产科杂志2025，Vol.41Issue(3)：338-342,5.DOI:10.19538/j.fk2025030116
自然妊娠与体外受精-胚胎移植受孕子宫腺肌病患者母儿结局对比分析
Analysis of maternal and fetal outcomes in patients with adenomyosis conceived naturally or by IVF-ET
摘要
Abstract
Objective To analyze the maternal and fetal outcomes of patients with adenomyosis conceived naturally or through in vitro fertilization and embryo transfer(IVF-ET).Methods We collected clinical data from 151 patients with adenomyosis who had pregnancy outcomes and were admitted to Peking University People's Hospital from January 2015 to December 2023.Based on the mode of conception we divided the patients into two groups:natural pregnancy group and IVF-ET group and analyzed the pregnancy outcomes of the two groups retrospectively.Results Among the 151 patients,there were 90 in the natural pregnancy group and 61 in the IVF-ET group.There was no statistically significant difference in the incidence of inevitable miscarriage(14 cases)between the two groups(8.9％,9.8％;P=0.844).The remaining 137 patients gave live births,82 patients were in the natural pregnancy group and 55 patients were in the IVF-ET group.The incidence of hypertensive disorders of pregnancy in IVF-ET group was significantly higher than that of natural pregnancy group(30.9％,15.9％;P=0.037),and the incidence of hospitalization maintenance for threatened abortion or threatened premature labor of the IVF-ET group was also significantly higher than that of natural pregnancy group(25.5％,9.8％;P=0.014).Compared with natural pregnancy group,the median of postpartum blood loss in IVF-ET group was significantly higher(400mL,500mL,P=0.001).Further comparison of postpartum blood loss between the two groups according to the mode of delivery:the median postpartum blood loss for cesarean section patients in the IVF-ET group was 500mL,significantly higher than that of the natural pregnancy group,which was 422.5mL(P=0.006);the median postpartum blood loss for vaginal delivery in the IVF-ET group and the natural pregnancy group were 530mL and 380mL,respectively,with no statistically significant difference(P=0.153).In multivariate logistic regression showed that IVF-ET was an independent risk factor for hypertensive disorders of pregnancy in patients with adenomyosis(OR=4.029,95％CI 1.365-1 1.890,P=0.012).Conclusions Compared with patients with adenomyosis conceived naturally,patients conceived by IVF-ET are prone to hypertensive disorders of pregnancy,hospitalization maintenance for threatened abortion or threatened premature labor and increased amount of postpartum bleeding.And IVF-ET was an independent risk factor for hypertensive disorders of pregnancy in patients with adenomyosis.During pregnancy,it is necessary to strengthen monitoring of patients with adenomyosis who conceived through IVF-ET,and to enhance the prevention of postpartum hemorrhage during the delivery process to improve maternal and fetal outcomes.关键词
子宫腺肌病/体外授精-胚胎移植/妊娠期高血压/母儿结局Key words
adenomyosis/in vitro fertilization and embryo transfer/hypertensive disorders of pregnancy/maternal and fetal outcomes分类
医药卫生引用本文复制引用
卢潇菲,王伊玲,卢欣蕾,昌晓红,祝洪澜..自然妊娠与体外受精-胚胎移植受孕子宫腺肌病患者母儿结局对比分析[J].中国实用妇科与产科杂志,2025,41(3):338-342,5.基金项目
北京市自然科学基金(7222206) （7222206）
北京大学人民医院研究与发展基金(科研)(RDL2022-47) （科研）
