Abstract: Objective To analyze the differences in clinical characteristics of twin premature infants between assisted reproductive technology (ART) conception and natural conception,in order to provide reference for perinatal healthcare. Methods A total of 2 900 twin premature infants delivered in 53 hospitals in 17 cities of Henan Province from January 1st,2019 to December 31st,2019 were selected as participants,and were divided into ART conception group (n=604) and natural conception group (n=2 296). The infants' general characteristics,complications,treatment and outcomes,as well as their mothers' perinatal conditions were compared and analyzed. Results The average age,the proportion of advanced age,the utilization rate of antenatal corticosteroid and cesarean section rate of the ART group were higher than those in the natural conception group (t=7.254,χ²=10.319,7.735,4.855,P<0.05). And the incidence rates of gestational hypertension and gestational diabetes in the ART group were significantly higher than those in the natural conception group (χ²=23.664,54.040,P＜0.01). The average gestational age of preterm infants in the ART group was lower than that in the natural conception group,and the ratio of gestational age less than 34 weeks and the asphyxia rate were higher than those in the natural conception group (t=-2.298,χ²=8.780,6.315,P＜0.05). But there were no significant differences in the main complications,treatment and outcomes between the two groups (P>0.05). Conclusions The maternal age,the proportion of advanced age,the incidence of gestational hypertension and gestational diabetes of the ART are higher than those of natural pregnancy. But ART does not increase the risk of short-term adverse outcomes for twin preterm infants. In view of the small gestational age and high suffocation rate of the twin preterm infants,the infants should be paid close attention during perinatal care and management.

Key words: preterm birth, assisted reproductive technology, twin pregnancy, clinical outcomes

摘要： 目的 分析辅助生殖技术(ART)受孕与自然受孕双胎早产儿临床特征的差异,为母婴围生期保健和临床工作提供参考价值。方法 选取2019年1月1日—12月31日河南省17地市53家医院产科分娩的2 900例双胎早产儿为研究对象,按受孕方式不同分为ART受孕组(n=604)及自然受孕组(n=2 296),收集其一般情况、住院期间并发症、治疗和结局情况及其母亲妊娠期情况等临床资料,并进行比较分析。结果 ART组早产儿母亲平均年龄、高龄比例、产前糖皮质激素使用率及剖宫产率高于自然受孕组(t=7.254,χ²=10.319、7.735、4.855,P＜0.05),妊娠期高血压及妊娠期糖尿病发生率明显高于自然受孕组(χ²=23.664、54.040,P＜0.01);ART组早产儿平均胎龄低于自然受孕组,胎龄＜34周比例及窒息率高于自然受孕组(t=-2.298,χ²=8.780、6.315,P＜0.05),两组早产儿主要并发症、治疗及结局情况比较,差异均无统计学意义(P＞0.05)。结论 ART受孕双胎早产儿母亲平均年龄、高龄产妇比例及妊娠期高血压、妊娠期糖尿病发生率较自然受孕者高;ART未增加双胎早产儿近期不良结局的风险,但其出生胎龄较小,窒息率较高,因此围生期保健及管理时需给予高度关注。

关键词: 早产, 辅助生殖技术, 双胎, 临床结局