보조생식술시 원인불명 불임환자의산과적 결과에 대한 고찰
Obstetric Outcome of Unexplained Infertility Patients FollowingAssisted Reproductive Technology
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목적 : 본 연구는 원인불명 불임환자가 보조생식술 시행 후 임신된 경우 자연임신과 산과적 예후 및 주산기 예후를 비교, 분석하고자 하였다. 연구 방법 : 1999년 1월부터 2002년 2월까지 성균관의대 삼성제일병원에 내원하여 최종적으로 진단복강경으로 원인불명불임으로 진단받고 보조생식술 시행 후 임신된 단태임신 79예와 연령과 산과력을 고려한 동일기간의 172예의 자연임신군간에 산과적, 주산기 합병증을 후향적으로 비교, 분석하였다. 통계처리는 Chi-square test 및 t-test를 시행하였고 p<0.05인 경우를 유의한 차이가 있다고 판정하였다. 결과 : 보조생식술을 시행받은 원인불명 불임환자군이 자연임신군에 비해 분만시 제태연령 (38.2±0.5주 vs. 39.4±0.1주, p<0.001)이 유의하게 낮고, 임신성 당뇨병 (7.6% vs. 1.2%, p<0.01)이 유의하게 증가하였다. 자간전증, 임신주수대비 저체중아, 양수과소증, 주산기 사망률, 제왕절개술의 빈도, 조기진통, 신생아의 1분, 5분 아프가 점수 등은 두 군간 유의한 차이가 없었다. 결론 : 자연임신인 경우와 비교하여 보조생식술에 의한 원인불명 불임환자의 임신은 분만시 제태연령이 낮았지만 조산은 증가하지 않았으며, 임신성 당뇨병 이외의 주산기 합병증은 증가하지 않았다.
Abstract
Objective : This study was aimed to evaluate the obstetric and perinatal outcomes of women with unexplained infertility following assisted reproductive technology (ART). Methods : From January 1999 to February 2002, a total of seventy-nine singleton pregnancies which progressed beyond 20 weeks gestation following embryo transfer in women finally diagnosed as unexplained infertility by diagnostic laparoscopy were enrolled in this study. The matched control was spontaneously conceived 172 singleton pregnancies. Retrospectively, we analyzed the obstetric outcome and compared gestational age at delivery, birth weight, Apgar score, and the incidence of perinatal mortality, preterm labor, preeclampsia, gestational diabetes mellitus, and oligohydramnios between two groups. Results : The mean gestational duration of study group was shorter than control group (38.2±0.5 vs. 39.4±0.1 weeks, p=0.001). The incidence of gestational diabetes mellitus was significantly higher in the study group (7.6% vs. 1.2%, p=0.01). There was no significant difference in the mean birth weight (3088.1±86.1 g vs. 3243.8±37.2 g), the incidence of small for gestational age (10.1% vs. 11.6%), preeclampsia (3.8% vs. 2.3%), oligohydramnios (3.8% vs. 5.8%), preterm labor (7.6% vs. 5.2%), cesarean delivery (45.6% vs. 41.3%), and perinatal mortality (1.3% vs. 0.6%) between the two groups. Conclusion : The gestational duration of women with unexplained infertility after IVF-ET was shorter, but the incidence of preterm birth was not increased. And the incidence of gestational diabetes mellitus of study group was higher than that of spontaneously conceived pregnancies.
참고문헌 (22)
- "조사보고서 한국 보조생식술의 현황", 46, pp.1888~1904 (2003)
- "Obstetric outcome in singleton pregnancies after assisted reproduction", 86, pp.188~192 (1995)
- "The increased risk of complication observed in singleton pregnancies resulting from in vitro fertilization does not seem to be related to the IVF method itself", 8, pp.1297~1300 (1993)
- "MRC working party on children conceived by in vitro fertilization: Births in Great Britain resulting from assisted conception, 1978-87", 300, pp.1229~1233 (1990)
- "Singleton pregnancy after in vitro fertilization:Expectation and outcome", 86, pp.906~910 (1995)
- "Obstetric outcome of in vitro fertilization pregnancies compared with normally conceived pregnancies", 167, pp.778~784 (1992)
- "An audit of the obstetric outcome of 148 consecutive pregnancies from assisted conception Implication for neonatal services", 100, pp.820~825 (1993)
- "Obstetric outcome of twin pregnancies after in vitro fertilization: a matched control study in four Dutch university hospitals", 15, pp.935~940 (2000)
- "Perinatal outcome of pregnancies after assisted reproduction:a case-control study", 10, pp.575~580 (1997)
- "Is the obstetric outcome of in vitro fertilized singleton gestations different from natural ones?", 67, pp.1077~1083 (1997)
- "The Obstetric outcome of singleton pregnancies following in vitro fertilization", 9, pp.141~146 (1994)
- "The incidence, characteristics and prognosis of patients whose infertility is unexplained", 37, pp.175~182 (1982)
- "The prognosis for live birth among untreated infertile couples", 64, pp.22~28 (1995)
- "Obstetric outcome among women with unexplained infertility after IVF:a matched case-control study", 7, pp.1755~1761 (2002)
- "Diagnosing gestational diabetes mellitus:Use of glucose screen without administering the glucose tolerance test", 87, pp.395~400 (1996)
- "Obstetric outcome of singleton pregnancies after IVF:A matched control study", 15, pp.1819~1825 (2000)
- "Delivery outcome after infertility-a registry study", 55, pp.726~732 (1991)
- "Obstetric outcome in patients with unexplained infertility", 77, pp.849~853 (1998)
- "In vitro fertilization gamete intrafallopian transfer, and superovulation with intrauterine insemination: Efficacy and potential health hazard on babies delivered", 174, pp.1208~1217 (1996)
- "obstetric and neonatal outcome of pregnancy in women with a previous history of infertility: prospective study Br", 98, pp.1087~1092 (1991)
- "Elevated first trimester serum relaxin concentrations in pregnant women following ovarian stimulation predict prematurity risk and preterm delivery", 82, pp.821~828 (1993)
- "Review of unexplained infertility and obstetric:a 10-year review", 12, pp.2594~2597 (2001)