子宫内膜厚度对冻融胚胎移植胎儿出生体质量的影响

Effect of endometrial thickness on birth weight in frozen-thawed embryo transfer cycles

目的探讨冻融胚胎移植日子宫内膜厚度与胎儿出生体质量的关系。方法选取2016年6月至2018年12月期间于郑州大学第三附属医院生殖医学中心行冻融胚胎移植的1622个单胎活产周期进行回顾性队列分析,根据移植日子宫内膜厚度分为4组,A组:子宫内膜厚度≤8 mm;B组:子宫内膜厚度8~10 mm;C组:子宫内膜厚度10~12 mm;D组:子宫内膜厚度≥12 mm。比较各组患者的一般资料及临床数据,以A组为参照组,控制混杂因素,计算其他各组低出生体质量(low birth weight,LBW)、极低出生体质量(very low birth weight,VLBW)、足月LBW、小于胎龄儿(small for gestational age,SGA)、早产的优势比(odds ratio,OR)及95%置信区间(95%CI),并采用多元线性回归分析影响胎儿出生体质量的相关因素。结果4组胎儿的出生体质量依次为(3350.15±568.17)g、(3431.84±523.43)g、(3445.93±483.73)g、(3482.27±495.30)g,组间比较差异均无统计学意义(P>0.05)。经多因素逻辑回归分析校正混杂因素后,A组的早产风险大于C组(OR=0.527,95%CI=0.287~0.968,P=0.039),移植日子宫内膜厚度不影响LBW、VLBW、足月LBW、SGA发生率(P均>0.05)。多元线性回归分析显示体质量指数(body mass index,BMI)、移植胚胎阶段、分娩孕周、新生儿性别均会影响胎儿出生体质量(P<0.001,P=0.003,P<0.001,P<0.001)。结论在冻融胚胎移植周期中,移植日子宫内膜厚度≤8 mm的妇女发生早产的可能性比内膜厚度10~12 mm的妇女高,但子宫内膜厚度不影响胎儿出生体质量。

Objective To investigate the effect of endometrial thickness on birth weight in frozen-thawed embryo transfer cycles.Methods A retrospective cohort analysis of 1622 single-birth live birth cycles of frozen-thawed embryo transfer at the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from June 2016 to December 2018 was performed.According to the endometrial thickness on the day of transplantation,the patients were divided into four groups,group A:endometrial thickness≤8 mm;group B:endometrial thickness 8-10 mm;group C:endometrial thickness 10-12 mm;group D:endometrial thickness≥12 mm.The general and clinical data of patients in each group were compared.Group A was used as the reference group to control confounding factors and the low birth weight(LBW)and very low birth weight(VLBW),term LBW,small for gestational age(SGA),preterm birth odds ratio(OR),and 95%confidence interval(95%CI)were calculated,and multiple linear regression was used to analyze the impact factors related to the birth weight of the fetus.Results The fetal birth weights of the four groups were(3350.15±568.17)g,(3318.84±523.43)g,(3459.93±483.73)g,(3482.27±495.30)g in order(P>0.05).After adjusting for confounding factors through multivariate logistic regression analysis,the risk of preterm birth in group A was greater than that in group C(OR=0.527,95%CI=0.287-0.968,P=0.039).Endometrial thickness did not affect the incidence of LBW,VLBW,term LBW,and SGA(P>0.05).Further,multiple linear regression analyses indicated that body mass index,embryo transfer stage,gestation week,and newborn gender all affected the fetal birth weight(P<0.001,P=0.003,P<0.001,P<0.001).Conclusion In the frozen-thawed embryo transfer cycle,the women with endometrial thickness≤8 mm on the day of transplantation are more likely to have premature birth than women with endometrial thickness of 10-12 mm,but endometrial thickness does not affect the fetal birth weight.