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男性出生体重、精液质量与出生结局。

Male birthweight, semen quality and birth outcomes.

作者信息

Whitcomb B W, Bloom M S, Kim S, Chen Z, Buck Louis G M

机构信息

Department of Biostatistics and Epidemiology, University of Massachusetts, 715 N. Pleasant St., Amherst, MA 01002, USA.

Department of Environmental Health Sciences, University at Albany, State University of New York, One University Place, Rensselaer, NY 12144, USA.

出版信息

Hum Reprod. 2017 Mar 1;32(3):505-513. doi: 10.1093/humrep/dew345.

Abstract

STUDY QUESTION

What are the relations among birthweight (BW), semen parameters and birth outcomes in a population-based sample?

SUMMARY ANSWER

BW is unrelated to semen parameters, which are in turn unrelated to birth outcomes.

WHAT IS KNOWN ALREADY

In clinical settings, there has been suggestion that semen parameters are related to BW when comparing fertile and infertile men; however, findings have been less clear in more general populations.

STUDY DESIGN, SIZE, DURATION: Questionnaire data and semen samples were collected at baseline from 427 male participants of the population-based Longitudinal Investigation of Fertility and the Environment (LIFE) prospective cohort study from 2005 to 2009, who were followed prospectively to assess pregnancy outcomes among 226 singleton births.

PARTICIPANTS/MATERIALS, SETTING, METHODS: Men of at least 18 years of age who were married or in a committed relationship and trying to conceive were eligible for participation; physician-diagnosed infertility was an exclusion criterion. Participants were recruited from two geographic areas and semen samples were analyzed for 34 quality parameters categorized as general, motility, morphology, sperm head and sperm chromatin structure using methods including computer-aided semen analysis integrated visual optical system and sperm chromatin structure assay. Linear and mixed models were used for statistical analysis of the relations between men's BW, semen parameters, and BW, gestational age at delivery, birth length, head circumference and ponderal index of singleton births.

MAIN RESULTS AND THE ROLE OF CHANCE

No association was observed between male BW and semen parameters or birth outcomes. Few associations were observed between semen parameters and birth outcomes, and the observed statistically significant associations were isolated and without a consistent pattern that would suggest an association between BW and birth outcomes.

LIMITATIONS, REASONS FOR CAUTION: Men's BW was self-reported and may be subject to some imprecision. Semen analysis was performed the day after collection, an approach that impacts the assessment of motility and that may limit inference from our analyses of motility measures. In addition, inclusion criteria for selection into the cohort limits generalizability to generally healthy couples trying to conceive and without known subfertility.

WIDER IMPLICATIONS OF THE FINDINGS

Despite suggestions from prior studies of male in utero exposures impacting BW and male reproductive health, there appears to be little support for such relations in this generally healthy population.

STUDY FUNDING/COMPETING INTEREST(S): Supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (N01-HD-3-3355, N01-HD-3-3356 and NOH-HD-3-3358). The authors report no competing interests, and a Memo of Understanding with the National Institute of Occupational Safety and Health (NIOSH) for semen analysis.

TRIAL REGISTRATION NUMBER

Not applicable.

摘要

研究问题

在一个基于人群的样本中,出生体重(BW)、精液参数和出生结局之间有什么关系?

总结答案

出生体重与精液参数无关,而精液参数又与出生结局无关。

已知信息

在临床环境中,有人提出在比较可育和不育男性时,精液参数与出生体重有关;然而,在更广泛的人群中,研究结果并不那么明确。

研究设计、规模、持续时间:2005年至2009年,从基于人群的生育与环境纵向调查(LIFE)前瞻性队列研究的427名男性参与者中收集了问卷数据和精液样本,对这些参与者进行前瞻性跟踪,以评估226例单胎出生的妊娠结局。

参与者/材料、环境、方法:年龄至少18岁、已婚或处于稳定关系且正在尝试怀孕的男性有资格参与;医生诊断的不育症为排除标准。参与者从两个地理区域招募,使用包括计算机辅助精液分析集成视觉光学系统和精子染色质结构分析在内的方法,对精液样本进行34项质量参数分析,这些参数分为一般参数、活力参数、形态参数、精子头部参数和精子染色质结构参数。使用线性和混合模型对男性出生体重、精液参数以及单胎出生的出生体重、分娩时的孕周、出生身长、头围和 ponderal 指数之间的关系进行统计分析。

主要结果及偶然性的作用

未观察到男性出生体重与精液参数或出生结局之间存在关联。精液参数与出生结局之间观察到的关联很少,且观察到的具有统计学意义的关联是孤立的,没有一致的模式表明出生体重与出生结局之间存在关联。

局限性、注意事项:男性的出生体重是自我报告的,可能存在一定不准确性。精液分析在采集后第二天进行,这种方法会影响活力评估,可能会限制我们对活力测量分析的推断。此外,队列入选标准限制了研究结果对一般健康且正在尝试怀孕且无已知亚生育问题的夫妇的普遍适用性。

研究结果的更广泛影响

尽管先前有研究表明男性子宫内暴露会影响出生体重和男性生殖健康,但在这个一般健康的人群中,似乎几乎没有证据支持这种关系。

研究资金/利益冲突:由尤妮斯·肯尼迪·施莱佛国家儿童健康与人类发展研究所的内部研究项目资助(N01-HD-3-3355、N01-HD-3-3356和NOH-HD-3-3358)。作者声明无利益冲突,并与国家职业安全与健康研究所(NIOSH)就精液分析签订了谅解备忘录。

试验注册号

不适用。

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