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受孕方式似乎不会影响孕早期的胎盘体积。

Mode of conception does not appear to affect placental volume in the first trimester.

作者信息

Churchill Sara J, Wang Erica T, Akhlaghpour Marcy, Goldstein Ellen H, Eschevarria Dina, Greene Naomi, Macer Matthew, Zore Temeka, Williams John, Pisarska Margareta D

机构信息

Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Cedars-Sinai Medical Center, Los Angeles, California.

Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Cedars-Sinai Medical Center, Los Angeles, California; David Geffen School of Medicine, University of California, Los Angeles, California.

出版信息

Fertil Steril. 2017 Jun;107(6):1341-1347.e1. doi: 10.1016/j.fertnstert.2017.04.010. Epub 2017 May 10.

Abstract

OBJECTIVE

To study whether infertility treatments, including IVF and non-IVF fertility treatments, are associated with diseases of placental insufficiency in early gestation. First trimester placental volumes by ultrasound and chorionic villi weight during sampling (CVS) were performed to detect differences between pregnancies conceived spontaneously versus with fertility treatments.

DESIGN

Retrospective cohort.

SETTING

Academic tertiary center.

PATIENT(S): Women with singleton pregnancies undergoing CVS and first trimester ultrasound from April 2007 to November 2015.

INTERVENTION(S): Estimated placental volume (EPV) was calculated from ultrasound images using a validated computation and CVS estimated tissue weight was performed using a validated visual analogue scale.

MAIN OUTCOME MEASURE(S): Adjusted linear regression was used to compare EPV and CVS weight based on mode of conception.

RESULT(S): A total of 1,977 spontaneous and 334 conceived with fertility treatments (133 non-IVF and 201 IVF) pregnancies were included. Significant differences in maternal age, gravidity, hypertension, and smoking status were identified. EPV and CVS weight were correlated with maternal age, gestational age, and maternal hypertension. Adjusted linear regression showed no difference in EPV in pregnancies conceived with fertility treatments versus spontaneously. The CVS weight was significantly lower in the IVF conceptions in unadjusted univariate analyses. However, after adjusted regression, this was no longer significant.

CONCLUSION(S): Mode of conception does not appear to affect first trimester placental size. As differences in maternal age, hypertension, and smoking status differ among the groups and are correlated to placental size, it may be the underlying patient population leading to abnormal placentation and insufficiency, not the fertility treatments used.

摘要

目的

研究包括体外受精(IVF)和非IVF生育治疗在内的不孕治疗是否与妊娠早期胎盘功能不全疾病相关。通过超声测量孕早期胎盘体积,并在绒毛取样(CVS)时测量绒毛重量,以检测自然受孕与接受生育治疗的妊娠之间的差异。

设计

回顾性队列研究。

地点

学术三级中心。

患者

2007年4月至2015年11月期间接受CVS和孕早期超声检查的单胎妊娠妇女。

干预措施

使用经过验证的计算方法从超声图像计算估计胎盘体积(EPV),并使用经过验证的视觉模拟量表进行CVS估计组织重量。

主要观察指标

采用调整后的线性回归,根据受孕方式比较EPV和CVS重量。

结果

共纳入1977例自然受孕和334例接受生育治疗受孕(133例非IVF和201例IVF)的妊娠。确定了产妇年龄、妊娠次数、高血压和吸烟状况的显著差异。EPV和CVS重量与产妇年龄、孕周和产妇高血压相关。调整后的线性回归显示,接受生育治疗受孕的妊娠与自然受孕的妊娠在EPV方面无差异。在未调整的单变量分析中,IVF受孕的CVS重量显著较低。然而,经过调整回归后,这不再显著。

结论

受孕方式似乎不影响孕早期胎盘大小。由于各组之间产妇年龄、高血压和吸烟状况存在差异,且与胎盘大小相关,可能是潜在的患者人群导致胎盘植入异常和功能不全,而非所使用的生育治疗。

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Mode of conception does not appear to affect placental volume in the first trimester.受孕方式似乎不会影响孕早期的胎盘体积。
Fertil Steril. 2017 Jun;107(6):1341-1347.e1. doi: 10.1016/j.fertnstert.2017.04.010. Epub 2017 May 10.

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