滋养外胚层细胞活检对冻胚移植新生儿出生体质量的影响

Effect of trophoblast ectodermal cell biopsy on birth weight in frozen-thawed embryo transfer cycles.

目的:探讨胚胎植入前遗传学检测(PGT)中滋养外胚层细胞活检对新生儿出生体质量及围产期结局的影响。方法:回顾分析2017年1月至2021年12月在郑州大学第三附属医院生殖医学中心行冻胚移植(FET)并获得单胎活产患者的临床资料。纳入行胚胎植入前行遗传学检测的患者221例(PGT组)和同期行卵胞质内单精子注射(ICSI)的患者756例(ICSI组),利用倾向性评分匹配(PSM)进行1:2匹配后得到PGT组191例和ICSI组363例,比较匹配前后两组患者基线数据及新生儿出生体质量等围产期及新生儿结局的差异,采用多因素线性回归分析单胎活产新生儿出生体质量的影响因素。结果:匹配前两组患者的孕产次、不孕年限及移植日内膜厚度比较,差异有统计学意义(P<0.05),匹配后两组患者基线数据差异均无统计学意义(P均>0.05)。匹配前后,两组的妊娠期高血压疾病、妊娠期糖尿病、胎膜早破、前置胎盘、剖宫产率、分娩孕周、新生儿出生体质量及新生儿身长比较,差异均无统计学意义(P均>0.05)。多因素线性回归分析结果显示,滋养外胚层细胞活检与新生儿出生体质量无关,女方BMI、移植日子宫内膜厚度、分娩孕周和新生儿性别显著影响新生儿出生体质量(P均<0.05)。结论:PGT中滋养外胚层活检可能不会影响新生儿出生体质量,也不增加母婴不良并发症发生风险。

Objective:To investigate the effect of trophoectoderm biopsy during preimplantation genetic testing(PGT)on newborn birth weight.Methods:The clinical data of patients who underwent freeze-thawed embryo transfer(FET)in Reproductive Medicine Center of the Third Affiliated Hospital of Zhengzhou University from January 2017 to December 2021 were retrospectively analyzed.A total of 221 patients undergoing pre-implantation genetic testing(PGT group)and 756 patients undergoing intracytoplasmic sperm injection(ICSI group)were included.A total of 191 patients in the PGT group and 363 patients in the ICSI group were matched by 1:2 ProPensity score matching(PSM).Baseline data,neonatal birth weight and other perinatal and neonatal outcomes were compared between the two groups before and after matching.Multifactor linear regression was used to analyze the influencing factors of birth weight of single live births.Results:There were differences in the number of pregnancies,infertility years and endometrial thickness on transplantation day between the two groups before matching(P<0.05),and no statistical significance in baseline data between the two groups after matching(all P>0.05).There were no significant differences in the incidence of hypertensive diseases,gestational diabetes mellitus,premature rupture of membranes,placenta previa,cesarean section,gestational weeks,birth weight,birth length and birth defect rate between the two groups before and after matching(P>0.05).The results of multifactor linear regression analysis showed that trophoblastic ectodermal cell biopsy was not correlated with neonatal birth weight,but female BMI,endometrial thickness on transplantation date,gestational age and neonatal sex significantly affected neonatal birth weight(all P<0.05).Conclusion:Trophoblast ectoderm biopsy in PGT does not affect the birth weight of newborns and does not increase the risk of adverse complications.