Neonatal mortality and short term prognosis in newborns born after assisted reproduction techniques

Abstract

@font face { font family: Times ; }p MsoNormal li MsoNormal div MsoNormal { margin: 0cm 0cm 0 0001pt; font size: 12pt; font family: Times New Roman ; }div Section1 { page: Section1; }

Keywords

• -

Yardımcı üreme teknikleri ile sağlanan gebeliklerden doğan bebeklerde yenidoğan ölüm oranı ve kısa dönemdeki seyri

Abstract

Amaç: Günümüzde yard›mc› üreme tekniklerinin (YÜT) kullan›m›n›n artmas› ile birlikte, bu gebeliklere ba¤l› erken do¤um ve ço¤ul gebelik oranlar› da artm›flt›r. Bu çal›flmada, klini¤imizde YÜT ile sa¤lanan gebeliklerden do¤an bebeklerdeki yenido¤an hastal›k ölüm oran› ve k›sa dönem seyrin araflt›r›lmas› amaçlanm›flt›r.

Gereç ve Yöntem: Hastanemizde Ocak 2007-Aral›k 2007 tarihleri aras›nda YÜT ile gerçeklefltirilen gebeliklerden do¤an 123 bebek çal›flma grubu olarak al›nd›. Olgular›n dosyalar›ndan geriye dönük olarak perinatal ve yenido¤an döneme ait verileri, do¤ufltan anomali varl›¤›, erken do¤uma ba¤l› hastal›klar (kronik akci¤er hastal›¤›, kafa içine kanama, prematüre retinopatisi) ve yenido¤an ölüm oran›n›n sonuçlar› kaydedildi. Kaybedilen olgularda ölüme neden olan etkenler araflt›r›larak, YÜT bebeklerindeki seyir normal gebeliklerden do¤an bebeklerle de istatistiksel olarak karfl›laflt›r›ld›. ‹statistiksel analizlerde ba¤›ms›z örnekler için t-testi ve ki-kare testi kullan›ld›.

Bulgular: Çal›flma grubunu oluflturan 123 YÜT bebe¤inin %95,6’s› erken do¤mufltu ve ölüm oran› % 20,3 idi. Çal›flma grubunda do¤ufltan anomali s›kl›¤› %8,9, ço¤ul gebelik oran› %90,2 olarak bulundu. Normal gebeliklere göre YÜT bebeklerinde do¤um a¤›rl›¤›n›n daha düflük, ölüm oran›n›n ve do¤ufltan anomali s›kl›¤›n›n daha yüksek oldu¤u saptand›.

Çıkarımlar: Yard›mc› üreme teknikleri sonras›nda do¤an bebeklerde ço¤ul gebelik, düflük do¤um a¤›rl›¤› ve do¤ufltan anomali oran›n›n artm›fl oldu¤u, bu durumun hastal›k ve ölüm oran›nda art›fla neden oldu¤u kan›s›na var›lm›flt›r. 

Keywords

• Erken doğmuş bebek
• yardımcı üreme teknikleri
• yenidoğan ölüm oranı

References

1. Steptoe PC, Edwards RG. Birth after the reimplantation of a human embryo. Lancet 1978; 2: 366. (Abstract) / (Full Text)
2. Adamson GD, de Mouzon J, Lancaster P, Nygren KG, Sullivan E, Zegers-Hochschild F. World collaborative report on in vitro fertilization, 2000. Fertil Steril 2006; 85: 1586-622. (Abstract) / (Full Text) / (PDF)
3. Wright VC, Chang J, Jeng G, Macaluso M ; Centers for Disease Control and Prevention (CDC). Assisted reproductive technology surveillance- United States, 2005. MMWR Surveill Summ 2008; 57: 1-23. (Abstract) / (Full Text)
4. Klemetti R, Gissler M, Hemminki E. Comparison of perinatal health of children born from IVF in Finland in the early and late 1990s. Hum Reprod 2002; 17: 2192-8. (Abstract) / (Full Text) / (PDF)
5. MacGillivray I, Campbell DM. Management of twin pregnancies. In: MacGillivray I, Campbell DM, Thompson B, (eds). Twinning and Twins. John Wiley: Chichester, 1988: 111-39.
6. Malone FD, Kaufman GE, Chelmow D, Athanassiou A, Nores JA, D'Alton ME. Maternal morbidity associated with triplet pregnancy. Am J Perinatol 1998; 15: 73-7. (Abstract) / (PDF)
7. Ombelet W, Martens G, De Sutter P, et al. Perinatal outcome of 12021 singleton and 3108 twin births after non-IVF-assisted reproduction: a cohort study. Hum Reprod 2006; 21: 1025-32. (Abstract) / (Full Text) / (PDF)
8. Dhont M, De Neubourg F, Van Der Elst J, De Sutter P. Perinatal outcome of pregnancies after assisted reproduction: a case control study. J Assist Reprod Genet 1997; 14: 575-80. (Abstract) / (PDF)

9. Westergaard HB, Tranberg J, Erb K, Nyboe A. Danish national in-vitro fertilization registry 1994-1995: a controlled study of births, malformations and cytogenetic findings. Hum Reprod 1999; 14: 1896-902. (Abstract) / (Full Text) / (PDF)
10. Bonduelle M, Liebaers I, Deketelaere V, et al. Neonatal data on a cohort of 2889 infants born after ICSI (1991-1999) and of 2995 infants born after IVF (1983-1999). Human Reprod 2002; 17: 671-94. (Abstract) / (Full Text) / (PDF)
11. Senat MV, Ancel PY, Bouvier Colle MH, Bréart G. How does multipl pregnancy affect maternal mortality and morbidity? Clin Obstet Gynecol 1998; 41: 78-83. (Abstract)
12. The ESHRE Capri Workshop Group. Multipl gestation pregnancy. Hum Reprod 2000; 15: 1856-64. (Abstract) / (Full Text) / (PDF)
13. Bernasko J, Lynch L, Lapinski R, Berkowitz RL. Twin pregnancies conceived by assisted reproductive techniques: Maternal and neonatal outcomes. Obstet Gynecol 1997; 89: 368-72. (Abstract)
14. Daniel Y, Ochshorn Y, Fait G, Geva E, Bar-Am A, Lessing JB. Analysis of 104 twin pregnancies conceived with assisted repro- ductive techniques and 193 spontaneously conceived twin preg- nancies. Fertil Steril 2000; 74: 683-9. (Abstract) / (Full Text) / (PDF)
15. Moise J, Laor A, Armon Y, Gur I, Gale R. The outcome of twin preg- nancies after IVF. Hum reprod 1998; 13: 1702-5. (Abstract) / (PDF)
16. Jackson RA, Gibson KA, Wu YW, Croughan MS. Perinatal outcomes in singletons following in vitro fertilization: a metaanalysis. Obstet Gynecol 2004; 103: 551-63. (Abstract)
17. Helmerhorst FM, Perquin DA, Donker D, Keirse MJ. Perinatal outcome of singletons and twins after assisted conception: a systematic review of controlled studies. BMJ 2004; 328: 261. (Abstract) / (Full Text) / (PDF)
18. Aslan H, Cebeci A, Yıldırım G, Ceylan Y. Neonatal outcomes of twin pregnancies after assisted reproductive techniques. J Turkish German Gynecol Assoc 2005; 6: 111-3.
19. Müngen E, Tütüncü L. İkizden fazla sayıdaki çoğul gebelikler. Perinataloji 2001; 3:149-56. (Abstract)
20. Nayeri F, Aghahosseini M, Alyasin A, Nili F. Outcome of newborns conceived through artificial reproductive techniques in Tehran Iran. IJRM. 2006; 4: 57-62. (PDF)
21. Allen C, Bowdin S, Harrison RF, et al. Pregnancy and perinatal outcomes after assisted reproduction: a comparative study. Ir J Med Sci 2008; 177: 233-41. (Abstract) / (Full Text) / (PDF)
22. Al-Fifi S, Al-Binali A, Al-Shahrani M, et al. Congenital anomalies and other perinatal outcomes in ICSI vs naturally conceived pregnancies: a comparative study. J Assist Reprod Genet 2009; 26: 377-81. (Abstract) / (Full Text) / (PDF)
23. Pektas MK, Kunt C, Gungor T, Mollamahmutoglu L. Perinatal and first year outcomes of spontaneus versus assisted twins: a single center experience. Arch Gynecol Obstet 2008; 278: 143-7. (Abstract) / (Full Text) / (PDF)
24. Tuncbilek E, Boduroğlu K, Alikaşifoğlu M. Results of the Turkish congenital malformation survey. Turk J Pediatr 1999; 41: 287-97. (Abstract)
25. Koivurova S, Hartikainen AL, Gissler M, Hemminki E, Sovio U, Järvelin MR. Neonatal outcome and congenital malformations in children born after in-vitro feritlization. Hum Reprod 2002; 17: 5:1391-8. (Abstract) / (Full Text) / (PDF)
26. Stromberg B, Dahlquist G, Ericson A, Finnström O, Köster M, Stjernqvist K. Neurological sequelae in children born after in-vitro fertilization: a population-based study. Lancet 2002; 359: 461-5. (Abstract) / (Full Text) / (PDF)
27. Pinborg A, Loft A, Rasmussen S, et al. Neonatal outcome in Danish national cohort of 3438 IVF/ICSI and 10362 non-IVF/ICSI twins born between 1995 and 2000. Hum Reprod 2004; 19: 435-41. (Abstract) / (Full Text) / (PDF)