夫精宫腔内人工授精周期中子宫内膜厚度对新生儿不良结局的影响

Effects of endometrial thickness on neonatal adverse outcome during intrauterine artificial insemination by husband sperm cycle

目的:探讨夫精宫腔内人工授精周期中子宫内膜厚度是否对新生儿不良结局产生影响。方法:本研究为回顾性队列研究,纳入2016年1月至2018年1月接受夫精宫腔内人工授精治疗后单胎活产的1305例不孕症患者,按照峰值子宫内膜厚度的第10百分位数和第90百分位数分为子宫内膜较薄组(子宫内膜厚度≤7.3 mm)、子宫内膜正常组(7.3 mm<子宫内膜厚度≤12.8 mm)和子宫内膜较厚组(子宫内膜厚度>12.8 mm)3组。新生儿不良结局为低出生体重儿,小于胎龄儿以及早产。对新生儿不良结局进行logistic回归分析并调整混杂因素。结果:子宫内膜较薄组新生儿低出生体重、小于胎龄儿和早产的发生率分别为6.4%、7.6%和5.7%,子宫内膜正常组为4.6%、6.8%和5.7%,子宫内膜较厚组为2.8%、5.7%和5.0%,3组间新生儿不良结局发生率差异无统计学意义(P>0.05);内膜厚度对新生儿不良结局发生率无影响。结论:不孕症患者的子宫内膜厚度与夫精宫腔内人工授精周期中的新生儿不良结局无关。

Aim:To investigate whether the endometrial thickness has an influence on neonatal adverse outcome during the intrauterine artificial insemination by husband sperm cycle.Methods:This study is a retrospective cohort study.We enrolled 1305 infertility patients who received singleton live birth after intrauterine insemination treatment with husband′s sperm from January 2016 to January 2018.According to the 10th percentile and the 90th percentile of the peak endometrial thickness,all infertility patients were divided into three groups,thinner endometrial group(endometrial thickness≤7.3 mm),normal endometrial group(7.3 mm<uterine endometrial thickness≤12.8 mm)and thicker endometrium(endometrial thickness>12.8 mm).Neonatal adverse outcomes were low birth weight,small for gestational age,and premature delivery.Multiple logistic regression analysis was used to analyze the adverse outcome of newborns and adjust the confounding factors.Results:In the thinner endometrium group,the incidence of low birth weight,small for gestational age and premature birth in the three groups were 6.4%,7.6%,and 5.7%,those in the normal endometrium group were 4.6%,6.8%,and 5.7%,and those in the thicker endometrium group were 2.8%,5.7%,and 5.0%,respectively.There was no significant difference in the incidence of neonatal adverse outcomes among the three groups(P>0.05).The logistic regression analysis also showed that after adjusting the confounding factors,there was no correlation between endometrial thickness and neonatal adverse outcomes.Conclusion:The thickness of the endometrium had nothing to do with the neonatal adverse outcomes during the intrauterine insemination cycle of the husband′s sperm.