通讯作者: 赵悦淑, zyswr@163.com

DOI：10.12201/bmr.202512.00015

A Comparative Analysis of Prenatal Screening Choices: ART versus Natural Conception

• 摘要：背景：在临床实践中，辅助生殖技术（Assisted Reproductive Technology，ART）妊娠的孕妇常面临产前筛查方式选择的困惑，对于ART孕妇是否应选择与自然妊娠不同的产前筛查路径，以及如何选择最优策略，临床尚存争议。目的 ：分析ART妊娠与自然妊娠人群在产前筛查方式选择、各筛查方法如颈项透明层（Nuchal translucency，NT）、母血清学筛查（Maternal serum screening，MSS，唐氏筛查，唐筛），无创产前检测（Non-invasiveprenatal testing，NIPT）的高风险率及产前诊断率等方面的差异，为ART孕妇提供更精准、高效的产前筛查方案。方法 ：选取2021.01-2024.12 在郑州大学第三附属医院分娩的42332名单胎妊娠孕妇作为研究对象 ，根据受孕方式将其分为ART妊娠组1858名与自然妊娠组40474名，回顾性分析两组孕妇的NT、唐筛、NIPT的检查率及其高风险率、高龄孕妇的产前诊断检查率。采用比较采用χ2 检验或 Fisher 确切概率法进行组间比较，以P<0.05为差异有统计学意义。结果 ：ART组的NT检查率（88.43%）显著高于自然妊娠组（82.30%）。在非高龄人群中，ART组的NIPT检查率（37.19%）显著高于自然妊娠组（ 20.14%），而唐筛检查率显著（64.21% ）低于自然妊娠组（76.83%），在高龄人群中，ART组的NIPT检查率（42.79%）同样显著高于自然妊娠组（30.72%）。辅助生殖NT增厚率、唐筛高风险率、NIPT高风险率分别为0.79%、6.93%、1.01%，自然妊娠NT增厚率、唐筛高风险率、NIPT高风险率分别为0.60%、7.44%、0.97%，两组分别进行比较，差异无统计学意义。结论 ：ART孕妇更加重视产前筛查，追求更精准高效的产前筛查方式，对子代安全性更为重视。此外，ART组孕妇产前筛查高风险率未见明显增加，可见ART技术并未增加胎儿染色体异常的发生风险。

  关键词： ART; NT; 唐氏筛查; NIPT; 

   

  Abstract: Background: In clinical practice, women with pregnancies achieved through Assisted Reproductive Technology (ART) often face confusion regarding the choice of prenatal screening methods. There is ongoing clinical debate on whether ART pregnancies warrant a different prenatal screening pathway compared to naturally conceived pregnancies and how to determine the optimal strategy.Objective To analyze the differences in prenatal screening methods, high-risk rates of various screening methods such as nuchal translucency (NT), maternal serum screening (MSS, Downs screening, Downs test), and non-invasive prenatal testing (NIPT), and the prenatal diagnosis rates between ART pregnant women and natural pregnant women. This is to provide more accurate and efficient prenatal screening plans for ART pregnant women.Methods A total of 42,332 singleton pregnant women who delivered at the Third Affiliated Hospital of Zhengzhou University from January 2021 to December 2024 were selected as the research subjects. They were divided into the ART pregnancy group (1,858 cases) and the natural pregnancy group (40,474 cases) based on the mode of conception. The examination rates of NT, Downs screening, and NIPT, as well as the high-risk rates and prenatal diagnosis rates of the two groups of pregnant women were retrospectively analyzed. The differences between the two groups were compared using the χ2 test or Fishers exact probability method, with P < 0.05 considered statistically significant.Results The NT examination rate in the ART group (88.43%) was significantly higher than that in the natural pregnancy group (82.30%). Among non-elderly women, the NIPT examination rate in the ART group (37.19%) was significantly higher than that in the natural pregnancy group (20.14%), while the Downs screening examination rate was significantly lower (64.21% vs. 76.83%). Among elderly women, the NIPT examination rate in the ART group (42.79%) was also significantly higher than that in the natural pregnancy group (30.72%). The NT thickening rate, high-risk rate of Downs screening, and high-risk rate of NIPT in the ART group were 0.79%, 6.93%, and 1.01%, respectively, while those in the natural pregnancy group were 0.60%, 7.44%, and 0.97%, respectively. Comparisons between the two groups showed no statistically significant differences.Conclusion Women with ART pregnancies demonstrate a greater emphasis on prenatal screening, opting for more precise and efficient screening methods and showing heightened concern for offspring safety. Furthermore, the positive rate of prenatal screening in the ART group was not significantly increased, indicating that ART technology itself does not elevate the risk of fetal chromosomal abnormalities.

  Key words: ART; NT; Maternal; Serum Screening; NIPT

  提交时间：2025-12-04

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  1	2025-10-21	10.12201/bmr.202512.00015V1	下载

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