| Objective: To discuss the children born after in-vitro fertilization (IVF)and the newborn after natural conception about intrauterine growth situation,n eonatal complications and maternal complications, and then to evaluate thesafety and feasibility of assisted reproductive technology (ART) and toprovide guidance in clinical treatment.Method:264live-born babies (IVF group) including92cases ofsingletons,85twins, triplets1case including dead baby1case born of178mothers receiving IVF-ET in the second hospital of Hebei medical universityand256live-born babies (Naturally conceived group) including226caseswith single child,15cases of twins born of241naturally conceived motherswho were randomly chosen from the same hospital matched for the time andseas on of birth were studied from January2011to December2013. Thencompared two groups of maternal age, whether the mother is polytocous,cesarean section rate, premature birth rate, complications during pregnancyand fetal intrauterine distress, meanwhile compare the two groups about birthasphyxia of newborn babies, birth defects, growth conditions andcomplications after birth by clinical analysing of the test-tube babies andnaturally conceived group.All statistical analyses were performed withstatistical software SPSS13.0, applied t test about measuring data andchi-square test on enumeration data. Dates which were normally distributedwere showed as mean±standard deviation(x±s), P<0.05was consideredstatistically significant.Result:1The comparison about IVF group and natural conceived group inmultiple pregnancies and preterm: IVF group of multiple pregnancy rate was 48.3%(86/178) and naturally conceived group was6.2%(15/241), there wasstatistically significant (X2was99.145, P<0.05); IVF group of preterm ratewas40.4%(72/178) and naturally conceived group was19.5%(47/241),difference between the two groups was statistically significant (X2was22.092,P<0.05).2The comparison of the maternal age and cesarean section rate IVFgroup and natural conception: IVF group of maternal average age was33.53±4.69and maternal average age in naturally conceived group was27.76±3.93, difference between the two groups was statistically significant (tis13.337, P<0.05); cesarean delivery rate in IVF group was81.5%(145/178)and naturally conceived group was51.0%(123/241),difference between thetwo groups was statistically significant (X2was41.111, P<0.05).3Thecomparison of gestational diabetes and high blood pressure during pregnancy(hereinafter referred to as Pregnancy hypertension) of IVF group and naturalconception: in the IVF group mothers who were suffered from gestationaldiabetes were9.0%(16/178) and naturally conceived group were4.1%(10/241), difference between the two groups was statistically significant (X2was4.120, P<0.05).IVF group mothers who were ill with Pregnancyhypertension rate was25.8%(46/178) or naturally conceived group was14.5%(35/241),then the difference between the two groups was statisticallysignificant (X2was8.413, P<0.05).4In IVF group placental abnormality ratewas4.5%(8/178); abnormality of umbilical cord rate was18.0%(32/178);premature rupture of membranes rate was14.0%(25/178).In groupnaturally conceived the placental abnormality rate was5.4%(13/241);umbilical cord abnormality rate was21.2%(51/241);premature rupture ofmembranes at a rate of8.7%(21/241).Then the differences between twogroups of premature rupture of membranes and the placenta or umbilical cordabnormalities had all no statistical significance (P>0.05).5IVF group andnaturally conceived in the intrauterine distress and birth asphyxia ofcomparison: IVF group of intrauterine distress rate was6.7%(12/178) andnaturally conceived group was3.3%(8/241); IVF group birth asphyxia ratewas10.6%(28/264) and naturally conceived group was7.8%(20/256).The two groups in intrauterine distress or birth asphyxia differences had nostatistical significance (P>0.05).6In IVF group newborn test-tube babies ofthe264cases who were transferred to pediatrics had114cases,accounting for43.2%(114/264).In naturally conceived group newborns of256cases whowere transferred to pediatrics was81cases, accounting for31.6%(81/256).Then the difference between two groups was statistically significant(X2was7.386, P<0.05).7In the aspect of intrauterine growth, IVF group lessthan gestational age rate was8.3%(22/264); suitable for gestational ageaccounted for85.6%(226/264); greater than the gestational age was6.1%(16/264).Then naturally conceived group which respectively accounted for7.8%(20/256),83.2%(213/256),9.0%(23/256), between two groups in theintrauterine growth there was no statistically significant (X2was1.614,P>0.05).8IVF group of neonatal respiratory distress syndrome (NRDS) andhyperbilirubinemia were significantly higher than that of natural conceptiongroup, respectively accounted for9.8%(26/264) and4.7%(12/256),22.3%(59/264) and14.1%(36/256),and the differences of the two were statisticallysignificant(X2were respective5.111and5.976, P<0.05).IVF group withcongenital malformation rate was9.8(26/264) or naturally conceived groupwas5.1%(13/256), so the difference of the two was statistically significant(X2was4.263, P<0.05).9IVF group about pulmonary hemorrhage, apnea andhypoglycemia incidence rate were respective3.8%(10/264),12.5%(33/264),13.6%(36/264) and naturally conceived group were ordinal3.1%(8/256),9.4%(24/256),9.8%(25/256). Apparently the former are higher than the latter,but there was no statistically significant difference (P>0.05). Naturallyconceived group of pneumonia and electrolyte abnormalities （includedhyponatremia hypocalcemia and hypokalemia） slightly higher than that oftest-tube baby group, those incidence respectively was19.5%(50/256) and17.0%(45/264),13.7%(35/256) and11.4%(30/264), the differences of thetwo had no statistically significant (P>0.05). Conclusion:1Polyembryony, cesarean section and premature birth incidence of IVFgroup obviously higher than that of natural conception.2Pregnancy hypertension, gestational diabete and maternal age of IVFgroup was obviously higher than that of natural conception which willinordinately affect the quality life of the newborns.3Some neonatal complications arose from the particularity of test-tubebabies, this study showed that test-tube baby group of neonatal respiratorydistress syndrome, hyperbilirubinemia and congenital malformation incidencerate obviously higher than that of naturally conceived group,but there is nosignificant difference in pneumonia, pulmonary hemorrhage, apnea, bloodglucose and electrolyte abnormalities.4Between IVF group and natural conception group there is nosignificant difference in intrauterine growth.5Reduce the multiple pregnancy of test-tube and closely monitorperinatal complications of multiple pregnancy,consequently lower pretermbirth is the key to improve the quality of IVF neonatal survival rate andsurvival. |
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