HRT-FET周期中雌激素水平与妊娠期高血压发生的关系  

Association between estrogen level and incidence of HDP after HRT-FET

作　　者：鲁娟娟[1] 邵雨菡 张倩[1] 倪天翔[1] 王泽[1] 李敬[1] 颜军昊[1,2] Lu Juanjuan;Shao Yuhan;Zhang Qian(Center for Reproductive Medicine,Shandong University,National Research Center for Assisted Reproductive Technology and Reproductive Genetics,The Key Laboratory of Reproductive Endocrinology(Shandong University),Ministry of Education,Jinan 250021)

机构地区：[1]山东大学生殖医学中心,国家辅助生殖技术和生殖遗传学研究中心,山东大学生殖内分泌教育部重点实验室,济南250021 [2]山东大学齐鲁医学院,济南250000

出　　处：《现代妇产科进展》2024年第1期37-40,46,共5页Progress in Obstetrics and Gynecology

基　　金：基金资助:国家重点研发计划(No:2021YFC2700604);山东省重点研发计划(No:2021LCZX02)。

摘　　要：目的:探讨替代方案冻胚移植(HRT-FET)周期中患者补充孕激素前的雌激素水平对妊娠期高血压疾病(HDP)发生的影响。方法:回顾分析2017年5月至2022年5月于山东大学生殖医学中心经HRT-FET获单胎活产的3506例患者的临床资料。根据E 2水平将患者分成3组:组1(E_(2)≤137pg/mL,≤25%,866例),组2(137pg/mL<E_(2)≤240pg/mL,25.01%~75%,1806例),组3(E_(2)>240pg/mL,>75%,834例)。比较3组患者的妊娠期并发症及新生儿结局。结果:组3患者的HDP发生率明显高于组1(aOR=0.653,95%CI为0.463~0.920,P=0.015)及组2(aOR=0.750,95%CI为0.566~0.994,P=0.045)。各组间妊娠期糖尿病、前置胎盘、产后出血等妊娠期并发症及早产、过期产、SGA(小于胎龄儿)、LGA(大于胎龄儿)等新生儿不良结局发生率无显著差异。结论:替代方案冻胚移植周期中转化内膜前的高雌激素水平是妊娠期高血压疾病发生的独立风险因素。Objective:To explore the effect of serum estrogen level(E_(2))prior to progesterone administration on incidence of hypertensive disorders of pregnancy(HDP)in singletons born after frozen embryo transfer(FET)using hormone replacement therapy(HRT)cycles.Method:This retrospective study included 3506 singletons after HRT-FET from May 2017 to May 2022.Patients were divided into 3 groups according to the serum E_(2)levels before endometrial transformation:Group 1(E_(2)≤137pg/mL),Group 2(137pg/mL<E_(2)≤240pg/mL),Group3(E_(2)>240pg/mL).The incidence of obstetric complications and perinatal outcomes were compared among groups.Results:The incidence of HDP was statistically increased in Group 3 compared with Group 1(aOR=0.653,95%CI 0.463~0.920,P=0.015)and Group 2(aOR=0.750,95%CI 0.566~0.994,P=0.045).The incidences of gestational diabetes mellitus,placenta previa,postpartum hemorrhage,preterm labor,post-term labor,large for gestational age(LGA),small for gestational age(SGA)were comparable among groups.Conclusion:High E 2 level was an independent risk factor for HDP in patients with singletons born after HRT-FET.

关 键 词：激素替代疗法 冻胚移植 雌二醇 妊娠期高血压疾病 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学]