Section of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Louisiana State University School of Medicine, New Orleans, and The Fertility Institute of New Orleans, Mandeville, LA.
Am J Obstet Gynecol. 2013 Oct;209(4):349.e1-6. doi: 10.1016/j.ajog.2013.05.052. Epub 2013 May 30.
To analyze the effects of preconception maternal height and weight on the risk of preterm singleton and twin births resulting from in vitro fertilization (IVF).
We performed a retrospective cohort analysis of the incidence of very early preterm birth (VEPTB), early preterm birth (EPTB), and preterm birth (PTB), before 28, 32, and 37 completed weeks, respectively, in 60,232 singleton and 24,111 twin live births using 2008-2010 live birth outcome data from the Society for Reproductive Technology Clinic Outcome Reporting System.
Maternal obesity is associated with significantly increased risk of VEPTB, EPTB, and PTB in pregnancies conceived by IVF. For morbidly obese women (body mass index ≥35) with singletons, rates of VEPTB, EPTB, and PTB were 1.7%, 3.6%, and 16.4%, with adjusted risk ratios (aRRs) and 95% confidence levels (CIs) of 2.6 (1.8-3.6), 2.2 (1.8-2.6), and 1.5 (1.4-1.7) using corresponding rates for normal body mass index (95% CI, 18.6-24.9) as referent. For morbidly obese women with twins, rate of VEPTB and EPTB were 6.5% and 12.5%, with aRRs and 95% CIs of 2.4 (1.8-3.0) and 1.5 (1.3-1.8). For singletons, the rate of PTB for short stature women (<150 cm) was 14.2%, as compared with 11.8% in those women with height ranging between 160-167 cm (referent), with aRRs and 95% CIs of 1.2 (1.0-1.4).
Preconception maternal obesity and short stature are associated with significantly increased risk of VEPTB and early preterm singleton and twin births in pregnancies resulting from IVF.
分析体外受精(IVF)受孕前母亲身高和体重对早产单胎和双胞胎出生风险的影响。
我们对 2008 年至 2010 年来自生殖技术学会临床结果报告系统的活产结局数据进行了回顾性队列分析,共纳入 60232 例单胎活产和 24111 例双胎活产,分别分析了极早早产(VEPTB)、早期早产(EPTB)和早产(PTB)在 28、32 和 37 周前的发生率。
肥胖母亲与 IVF 受孕的 VEPTB、EPTB 和 PTB 风险显著增加相关。对于肥胖(体重指数≥35)的单胎母亲,VEPTB、EPTB 和 PTB 的发生率分别为 1.7%、3.6%和 16.4%,调整后的风险比(aRR)和 95%置信区间(CI)分别为 2.6(1.8-3.6)、2.2(1.8-2.6)和 1.5(1.4-1.7),相应的正常体重指数(95%CI,18.6-24.9)为参考。对于肥胖的双胞胎母亲,VEPTB 和 EPTB 的发生率分别为 6.5%和 12.5%,aRR 和 95%CI 分别为 2.4(1.8-3.0)和 1.5(1.3-1.8)。对于单胎母亲,身高<150cm 的矮小母亲 PTB 的发生率为 14.2%,而身高在 160-167cm 之间的母亲的发生率为 11.8%(参考),aRR 和 95%CI 分别为 1.2(1.0-1.4)。
受孕前母亲肥胖和矮小与 IVF 受孕的 VEPTB 和早产单胎和双胞胎出生风险显著增加相关。