不同体质量指数对胚胎植入前染色体非整倍性检测助孕患者妊娠结局的影响  

Effect of different body mass index on pregnancy outcome in preimplantation genetic testing for aneuploidy

作　　者：陆晓黎 孙凯旋 周静 张伊彤 修银玲 于月新 于佳平 Lu Xiaoli;Sun Kaixuan;Zhou Jing;Zhang Yitong;Xiu Yinling;Yu Yuexin;Yu Jiaping(Department of Reproductive Medicine,General Hospital of Northern Theater Command,Shenyang 110000,China)

机构地区：[1]北部战区总医院生殖医学科,沈阳110000

出　　处：《中国临床实用医学》2024年第4期28-32,共5页China Clinical Practical Medicine

基　　金：辽宁省科学技术计划项目(2020JH2/10300118);2023年度军队护理创新与培育专项计划(2023HL070)。

摘　　要：目的探讨不同体质量指数(BMI)对胚胎植入前染色体非整倍性检测(PGT-A)助孕患者妊娠结局的影响。方法本研究为回顾性病例对照研究,选取2016年1月至2021年12月于北部战区总医院生殖医学科行胚胎PGT-A助孕的451例女性患者,年龄(37.4±4.4)岁,年龄范围为27~41岁。根据世界卫生组织的标准,按照患者进移植周期时的体质量指数进行分组。BMI<18.5 kg/m^(2)为低体质量组(n=50);BMI在18.5~24.9 kg/m^(2)为正常体质量组(n=176);BMI在25.0~29.9 kg/m^(2)为高体质量组(n=163);BMI≥30 kg/m^(2)为肥胖组(n=62)。分析不同BMI对PGT-A助孕妊娠结局的影响。结果低体质量组、正常组、高体质量组、肥胖组临床妊娠率分别为54.0%(27/50)、49.4%(87/176)、50.3%(82/163)、45.2%(28/62);活产率分别为46.0%(23/50)、42.6%(75/176)、43.6%(71/163)、29.0%(18/62);临床流产率分别为8.0%(4/50)、6.8%(12/176)、6.7%(11/163)、16.1%(10/62),四组间比较差异均有统计学意义(P<0.05)。多因素logistic回归分析结果显示,≥30.0 kg/m^(2)是影响PGT-A胚胎移植活产率的影响因素(OR=0.143,95%CI:0.096~0.212,P<0.05)。结论肥胖女性在PGT-A助孕胚胎移植后临床活产率低于体质量正常的女性,除胚胎原因外,肥胖也是导致患者低活产率的重要因素。Objective To explore the effect of different body mass index(BMI)on pregnancy outcomes in preimplantation genetic testing for aneuploidy(PGT-A).Methods This study was a case-control retrospective study,a total of 451 female patients who underwent PGT-A for fertilization at the department of Reproductive Medicine in the General Hospital of Northern Theater Command from January 2016 to December 2021 were selected,aged(37.4±4.4)years old,with an age range of 27 to 41 years old.The patients were grouped according to their BMI at the time of entering the transplantation cycle according to the World Health Organization criteria.BMI<18.5 kg/m^(2) was the low body mass group(n=50);BMI at 18.5 to 24.9 kg/m^(2) was the normal body mass group(n=176);BMI at 25.0 to 29.9 kg/m^(2) was the high body mass group(n=163);BMI≥30 kg/m^(2) was the obese group(n=62).To analyze the effect of different BMI on pregnancy outcomes in PGT-A assisted conception.Results The clinical pregnancy rates in the low body mass group,normal body mass group,high body mass group and obese group were 54.0%(27/50),49.4%(87/176),50.3%(82/163),5.2%(28/62);live birth rates were 46.0%(23/50),42.6%(75/176),43.6%(71/163),29.0%(18/62);clinical abortion rate were 8.0%(4/50),6.8%(12/176),6.7%(11/163),16.1%(10/62),the differences were statistically significant(P<0.05).The results of multivariate logistic regression analysis showed that>30.0 kg/m^(2) was an influencing factor affecting the live birth rate of PGT-A embryo transfer(OR=0.143,95%CI:0.096 to 0.212,P<0.05).Conclusions Obese females have a lower rate of clinical live birth after PGT-A assisted embryo transfer than women with normal body mass,and in addition to embryonic causes,obesity was an important factor contributing to the low rate of clinical live birth in patients.

关 键 词：体质量指数 植入前染色体非整倍性检测 肥胖 生化妊娠 活产率 

分 类 号：R714.8[医药卫生—妇产科学]