多囊卵巢综合征对新鲜胚胎移植周期中单胎出生婴儿体质量的影响  

Effect of polycystic ovary syndrome on body weight of singleton infants in fresh embryo transfer cycle

作　　者：石琼瑶 石森林[1] 史昊 林芳旭 李梦萦 姜雪 郭艺红[1] Shi Qiongyao;Shi Senlin;Shi Hao;Lin Fangxu;Li Mengying;Jiang Xue;Guo Yihong(Reproductive Medicine Center of the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院生殖医学中心,郑州450052

出　　处：《中华生殖与避孕杂志》2022年第5期455-461,共7页Chinese Journal of Reproduction and Contraception

基　　金：国家自然科学基金(81701527,81571409)。

摘　　要：目的探讨新鲜胚胎移植周期中多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者出生婴儿体质量情况及其影响因素。方法回顾性队列研究2014年1月至2019年12月期间在郑州大学第一附属医院生殖医学中心行体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)助孕并有单胎活产的5087例患者的临床资料。患者根据不孕原因分为PCOS组(n=1095)和非PCOS组(记为对照组,n=3992),比较两组一般情况及出生婴儿体质量差异,logistic回归分析影响婴儿出生体质量的因素。结果第3日(day 3,D3)胚胎移植PCOS组临床妊娠率[69.0%(1248/1808)]、种植率[49.0%(1742/3555)]均高于对照组[59.1%(5661/9572)、42.0%(7577/18040),均P<0.001],而活产率[37.0%(670/1810)]低于对照组[49.0%(4697/9585),P<0.001]。第5日(day 5,D5)囊胚移植PCOS组种植率[63.1%(500/793)]、活产率[54.0%(425/787)]高于对照组[59.0%(1066/1806),P=0.042;48.0%(876/1825),P=0.013]。D5囊胚移植PCOS组婴儿出生体质量[(3459.76±527.11)g]、超重儿比例[14.35%(61/425)]高于对照组[(3391.61±521.38)g,P=0.028;8.22%(72/876),P<0.001]和D3胚胎移植PCOS组[(3389.24±555.06)g,P=0.018;9.25%(62/670),P=0.009],但低体质量儿比例[2.35%(10/425)]低于D5囊胚移植对照组[4.91%(43/876),P=0.029]和D3胚胎移植PCOS组[4.78%(32/670),P=0.042];logistic回归分析显示女方体质量指数(body mass index,BMI)影响D5囊胚移植的出生婴儿体质量(OR=1.12,95%CI=0.052~0.175,P<0.001);移植胚胎的发育时间影响PCOS患者的出生婴儿体质量(OR=1.52,95%CI=0.019~0.819,P=0.040)。结论PCOS患者D5囊胚移植可获得更高的活产率和更低的低出生体质量儿比例,对PCOS患者建议新鲜周期进行囊胚移植。Objective To explore the newborn birth weight and its influencing factors of polycystic ovary syndrome(PCOS)patients during fresh embryo transfer cycle.Methods In this retrospective cohort study,the clinical data of 5087 patients with singleton live births who underwent in vitro fertilization and embryo transfer(IVF-ET)in the Reproductive Medicine Center of the First Affiliated Hospital of Zhengzhou University from January 2014 to December 2019 were analyzed.The patients were categorized into PCOS group(n=1095)and non-PCOS group(referred to as control group,n=3992)according to the cause of infertility.The general conditions and birth weight of the two groups were compared,and logistic regression analysis was performed to identify the factors affecting birth weight.Results For embryo transfer on the 3rd day(day 3,D3),the clinical pregnancy rate[69.0%(1248/1808)]and the implantation rate[49.0%(1742/3555)]in PCOS group were higher than those in control group[59.1%(5661/9572)and 42.0%(7577/18040),all P<0.001],while the live birth rate[37.0%(670/1810)]was lower than that in control group[49.0%(4697/9585),P<0.001].For blastocyst transfer on the 5th day(day 5,D5),the implantation rate[63.1%(500/793)]and the live birth rate[54.0%(425/787)]in PCOS group were higher than those of control group[59.0%(1066/1806),P=0.042;48.0%(876/1825),P=0.013].The birth weight of the infants[(3459.76±527.11)g]and the proportion of overweight infants[14.35%(61/425)]in PCOS group of D5 blastocyst transfer were higher than those in control group[(3391.61±521.38)g,P=0.028;8.22%(72/876),P<0.001]and PCOS group of D3 embryo transfer[(3389.24±555.06)g,P=0.018;9.25%(62/670),P=0.009],but the proportion of low weight infants[2.35%(10/425)]was lower than that in control group of the D5 blastocyst transfer[4.91%(43/876),P=0.029]and PCOS group of D3 embryo transfer[4.78%(32/670),P=0.042].Logistic regression analysis showed that the level of female body mass index(BMI)affects the birth weight of D5 blastocyst transfer(OR=1.12,95%CI=0.052-0.175,P<0.001)

关 键 词：多囊卵巢综合征 出生婴儿体质量 新鲜移植 单囊胚移植 

分 类 号：R711.75[医药卫生—妇产科学] R714.8[医药卫生—临床医学]