Abstract | Cilj istraživanja: Odrediti perinatalni ishod jednoplodnih i višeplodnih trudnoća nakon
medicinski potpomognute oplodnje (MPO).
Materijal i metode: Retrospektivno je pregledana medicinska dokumentacija Klinike za
ženske bolesti i porode te su izdvojene žene koje su rodile živorođenu djecu iz jednoplodnih i
višeplodnih trudnoća nakon MPO u dvogodišnjem razdoblju, od 1. siječnja 2011. do 31.
prosinca 2012. godine. U istraživanje je uključeno 164 rodilje koje su zanijele nakon MPO od
kojih je 99 imalo jednoplodnu, a 65 višeplodnu trudnoću. Promatrane varijable bile su dob,
paritet, indeks tjelesne mase (kg/m2), navršeni tjedan poroda (prijevremeni ≤366/7 i terminski
≥37), način dovršetka porođaja (vaginalno i carski rez), porođajna masa novorođenčeta
(grami), trofičnost novorođenčeta (hipotrofično, eutrofično, hipertrofično) i Apgar zbroj
novorođenčeta (≤7, 8-10).
Rezultati: Među ispitivanim skupinama nije bilo značajne razlike u paritetu (P=0,396), broju
pobačaja (P=0,748), indeksu tjelesne mase na početku (P=0,613) i na kraju trudnoće
(P=0,932) te učestalosti preeklampsije (P=0,236), dok je razlika postojala u prosječnoj
životnoj dobi majke prilikom začeća (P=0,032). Utvrđena je statistički značajna razlika u
učestalosti prijevremenog porođaja (P<0,001) i načinu dovršetka porođaja (P<0,001). Žene s
blizanačkom trudnoćom u usporedbi sa ženama s jednoplodnom trudnoćom nakon MPO,
imaju veću učestalost rađanja novorođenčadi niske porođajne mase (P<0,001) i smanjenog ≤7
Apgar zbroja (P<0,001). Veća učestalost rađanja hipertrofične novorođenčadi nađena je u
jednoplodnim trudnoćama nakon MPO (P=0,005).
Zaključci: Nakon postupaka potpomognute oplodnje, višeplodne trudnoće imaju lošiji
perinatalni ishod od jednoplodnih trudnoća. |
Abstract (english) | Objective: To determine perinatal outcome of singleton and multiple pregnancies conceived
after assisted reproductive technologies (ART).
Materials and Methods: Medical documentation of Department of Gynecology and
Obstetrics has been retrospectively analyzed and women who gave birth to singleton and
multiple newborns after ART in a two-year period (from January 1st , 2011 to December 31st,
2012) have been selected. 164 pregnant women who conceived after ART (99 singleton and
65 multiple pregnancies) have been included into the research. The observed variables were
maternal age (years), parity, body mass index (kg/m2), week of delivery (≤ 366/7, ≥ 37), mode
of delivery (vaginal and cesarean section), birth weight (grams), newborn’s trophicity (small
for gestational age, appropriate for gestational age, large for gestational age) and Apgar score
(≤7, 8-10).
Results: There was no significant difference in parity (P=0,396), number of abortions
(P=0,748), body mass index at the beginning (P=0,613) and the end of a pregnancy (P=0,932)
and the frequency of preeclampsia (P=0,236) among the analyzed groups, while the clear
difference was seen in the average maternal age at conception (P=0,032). Statistically
significant difference in the frequency of preterm birth (P <0.001) and the mode of delivery (P
<0.001) has been proven. Women with twin pregnancies in comparison to women with
singleton pregnancies, after ART, have higher incidence of giving birth to infants with low
birth weight (P<0,001) and decreased Apgar score ≤ 7 (P <0.001). Higher incidence of giving
birth to large for gestational age newborns was found in singleton pregnancies after ART (P =
0.005).
Conclusions: After ART, multiple pregnancies have poorer perinatal outcome than singleton
pregnancies. |