薄型子宫内膜是新鲜胚胎移植单胎子代低出生体质量的危险因素  

Thin endometrium is an independent risk factor for low birth weight of singleton in fresh embryo transfer

作　　者：张俊韦 杜明泽 管一春[1] 王兴玲[1] 李真[1] 孙丽君[1] Zhang Junwei;Du Mingze;Guan Yichun;Wang Xingling;Li Zhen;Sun Lijun(Reproductive Center of the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院生殖医学科,郑州450052

出　　处：《中华生殖与避孕杂志》2022年第1期24-29,共6页Chinese Journal of Reproduction and Contraception

摘　　要：目的探讨薄型子宫内膜厚度(endometrial thickness,EMT)对新鲜胚胎移植周期单胎子代低出生体质量(low birth weight,LBW)的影响。方法回顾性队列研究分析2015年1月至2019年2月期间在郑州大学第三附属医院生殖医学科行体外受精(in vitro fertilization,IVF)或卵胞质内单精子注射(intracytoplasmic sperm injection,ICSI)助孕的患者资料,纳入新鲜卵裂期胚胎移植且分娩单胎子代周期,共2247个周期。根据人绒毛膜促性腺激素(human chorionic gonadotropin,hCG)注射日的EMT进行分组,A组:≤7.5 mm;B组:7.6~12.0 mm;C组:>12.0 mm,分别计算各组单胎子代出生体质量和LBW的发生率,并采用二元逻辑回归校正混杂因素。结果A组单胎子代出生体质量[3000(2525,3350)g]显著低于B组和C组[3350(3050,3650)g,3400(3100,3690)g;均P<0.001]。A组LBW的发生率[24.7%(20/81)]显著高于B组和C组[4.0%(57/1414),5.3%(40/752);均P<0.001],而B组和C组差异无统计学意义(P>0.05)。经逻辑回归分析,体质量指数(P=0.029)、hCG注射日雌激素水平(P=0.027)、EMT(P<0.001)、分娩孕周(P<0.001)及新生儿性别(P<0.001)是LBW的独立影响因素,即体质量指数较小、分娩孕周越小、hCG注射日雌激素水平≥4000 ng/L以及新生儿为女性时,LBW的发生率增加。以B组为对照组,A组LBW发生率显著增加,为LBW的独立危险因素(aOR=4.39,95%CI=1.85~10.46,P<0.001),而C组LBW发生率差异无统计学意义(aOR=0.90,95%CI=0.51~1.59,P=0.723)。结论在新鲜卵裂期胚胎移植周期中,薄型EMT单胎子代出生体质量下降,为LBW的独立危险因素。Objective To explore the effect of thin endometrial thickness(EMT)on the low birth weight(LBW)of singleton in fresh embryo transfer cycle.Methods It was a retrospective cohort study.The data of singleton deliveries achieved after fresh cleavage embryo transfer in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from January 2015 to February 2019 were included.A total of 2247 cycles were included and were divided into three groups depending on the EMT:group A≤7.5 mm,group B 7.6-12.0 mm and group C>12.0 mm.The major outcome measure was LBW.Binary logistic regression was performed to correct for confounding factors.Results Singleton birthweight was lower in group A[3000(2525,3350)g]compared with group B and group C[3350(3050,3650)g,3400(3100,3690)g,all P<0.001].The incidence of LBW in group A[24.7%(20/81)]was significantly higher than that in groups B and C[4.0%(57/1414),5.3%(40/752),all P<0.001],while there was no statistical difference between groups B and C(P>0.05).Body mass index(P=0.029),estrogen level on the human chorionic gonadotropin(hCG)trigger day(P=0.027),EMT(P<0.001),gestational age(P<0.001)and the gender of the newborn(P<0.001)were independent factors of LBW.The incidence of LBW increased when the body mass index and gestational age were smaller and estrogen level on the hCG trigger day was≥4000 ng/L.Taking group B as control group,the incidence of LBW in group A increased significantly and was an independent risk factor for LBW(aOR=4.39,95%CI=1.85-10.46,P<0.001),while the incidence of LBW in group C had no significant difference(aOR=0.90,95%CI=0.51-1.59,P=0.723).Conclusion In the fresh cleavage stage embryo transfer cycle,singleton birth weight was lower in thin EMT group.And thin EMT was an independent risk factor for LBW of singleton delivery.

关 键 词：胚胎移植 低出生体质量 薄型子宫内膜 

分 类 号：R714.8[医药卫生—妇产科学]