单囊胚移植后病态肥胖与妊娠结局：一项北美回顾性研究。
Morbid obesity and pregnancy outcomes after single blastocyst transfer: a retrospective, North American study.
作者信息
Russo Miguel, Ates Senem, Shaulov Talya, Dahan Michael H
机构信息
Department of Obstetrics and Gynaecology, The Ottawa Hospital, University of Ottawa, 501 Smyth Rd, Ottawa, ON, Canada, K1H 8L6.
Division of Reproductive Endocrinology and Infertility, McGill University, MUHC Reproductive Centre, 687 Avenue des Pins #58, Montreal, QC, Canada, H3A 1A1.
出版信息
J Assist Reprod Genet. 2017 Apr;34(4):451-457. doi: 10.1007/s10815-017-0883-9. Epub 2017 Feb 11.
PURPOSE
Maternal obesity has been shown to affect reproductive function and pregnancy outcomes following in vitro fertilization. More recently, studies have demonstrated lower live birth rates after single blastocyst transfer (SBT) in patients who are overweight or obese. However, the impact of morbid obesity on pregnancy outcomes after SBT has not been well elucidated. The present study aimed to determine whether morbid obesity has a detrimental impact on pregnancy outcomes after SBT in a North American population.
METHODS
A retrospective, cohort study including 520 nulliparous and multiparous women undergoing top-quality SBT between August 2010 and March 2014 at a University Health Centre in North America was conducted. Primary outcomes included: miscarriage rate, clinical pregnancy rate, and live birth rate. Subjects were divided into different BMI categories (kg/m), including <20, 20-24.9, 25.0-29.9, 30-40, and 40 or more.
RESULTS
The miscarriage rate per pregnancy for each group, respectively, was 36, 64, 59, 61, and 50% (p = 0.16); the clinical pregnancy (per patient) rate per group was 36, 52, 38, 26, and 10% (p = 0.009); and the live birth rate (per patient) per group was 35, 50, 38, 26 and 10% (p = 0.03).
CONCLUSION
Morbid obesity is a strong and independent predictor of poor pregnancy outcomes in patients undergoing top-quality SBT.
目的
母体肥胖已被证明会影响体外受精后的生殖功能和妊娠结局。最近，研究表明超重或肥胖患者单囊胚移植（SBT）后的活产率较低。然而，病态肥胖对SBT后妊娠结局的影响尚未得到充分阐明。本研究旨在确定病态肥胖是否对北美人群SBT后的妊娠结局有不利影响。
方法
进行了一项回顾性队列研究，纳入了2010年8月至2014年3月在北美一家大学健康中心接受高质量SBT的520名单胎和多胎未产妇。主要结局包括：流产率、临床妊娠率和活产率。受试者被分为不同的体重指数（BMI，kg/m）类别，包括<20、20-24.9、25.0-29.9、30-40以及40及以上。
结果
每组每次妊娠的流产率分别为36%、64%、59%、61%和50%（p = 0.16）；每组（每位患者）的临床妊娠率分别为36%、52%、38%、26%和10%（p = 0.009）；每组（每位患者）的活产率分别为35%、50%、38%、26%和10%（p = 0.03）。
结论
病态肥胖是接受高质量SBT患者妊娠结局不良的一个强有力的独立预测因素。
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