Sites Cynthia K, Wilson Donna, Barsky Maya, Bernson Dana, Bernstein Ira M, Boulet Sheree, Zhang Yujia
Department of Obstetrics and Gynecology, Baystate Medical Center, Springfield, Massachusetts.
Department of Epidemiology and Biostatistics, Baystate Medical Center, Springfield, Massachusetts.
Fertil Steril. 2017 Nov;108(5):784-790. doi: 10.1016/j.fertnstert.2017.08.035. Epub 2017 Sep 30.
To determine whether assisted reproductive technology (ART) cycles involving cryopreserved-warmed embryos are associated with the development of preeclampsia.
Retrospective cohort study.
IVF clinics and hospitals.
PATIENT(S): A total of 15,937 births from ART: 9,417 singleton and 6,520 twin.
INTERVENTION(S): We used linked ART surveillance, birth certificate, and maternal hospitalization discharge data, considering resident singleton and twin births from autologous or donor eggs from 2005-2010.
MAIN OUTCOME MEASURE(S): We compared the frequency of preeclampsia diagnosis for cryopreserved-warmed versus fresh ET and used multivariable logistic regression to adjust for confounders.
RESULT(S): Among pregnancies conceived with autologous eggs resulting in singletons, preeclampsia was greater after cryopreserved-warmed versus fresh ET (7.51% vs. 4.29%, adjusted odds ratio = 2.17 [95% CI 1.67-2.82]). Preeclampsia without and with severe features, preeclampsia with preterm delivery, and chronic hypertension with superimposed preeclampsia were more frequent after cryopreserved-warmed versus fresh ET (3.99% vs. 2.55%; 2.95% vs. 1.41%; 2.76 vs. 1.48%; and 0.95% vs. 0.43%, respectively). Among pregnancies from autologous eggs resulting in twins, the frequency of preeclampsia with severe features (9.26% vs. 5.70%) and preeclampsia with preterm delivery (14.81% vs. 11.74%) was higher after cryopreserved versus fresh transfers. Among donor egg pregnancies, rates of preeclampsia did not differ significantly between cryopreserved-warmed and fresh ET (10.78% vs. 12.13% for singletons and 28.0% vs. 25.15% for twins).
CONCLUSION(S): Among ART pregnancies conceived using autologous eggs resulting in live births, those involving transfer of cryopreserved-warmed embryos, as compared with fresh ETs, had increased risk for preeclampsia with severe features and preeclampsia with preterm delivery.
确定涉及冷冻复苏胚胎的辅助生殖技术（ART）周期是否与子痫前期的发生有关。
回顾性队列研究。
体外受精诊所和医院。
共有15937例ART分娩：9417例单胎和6520例双胎。
我们使用了关联的ART监测、出生证明和产妇住院出院数据，纳入2005年至2010年自体或供体卵子的常住单胎和双胎分娩。
我们比较了冷冻复苏胚胎与新鲜胚胎移植后子痫前期的诊断频率，并使用多变量逻辑回归调整混杂因素。
在自体卵子受孕的单胎妊娠中，冷冻复苏胚胎移植后子痫前期的发生率高于新鲜胚胎移植（7.51%对4.29%，调整后的优势比=2.17[95%CI 1.67-2.82]）。冷冻复苏胚胎移植后，无严重特征的子痫前期、有严重特征的子痫前期、早产子痫前期和慢性高血压并发子痫前期的发生率均高于新鲜胚胎移植（分别为3.99%对2.55%；2.95%对1.41%；2.76对1.48%；0.95%对0.43%）。在自体卵子受孕的双胎妊娠中，冷冻胚胎移植后有严重特征的子痫前期（9.26%对5.70%）和早产子痫前期（14.81%对11.74%）的发生率更高。在供体卵子妊娠中，冷冻复苏胚胎与新鲜胚胎移植后的子痫前期发生率无显著差异（单胎为10.78%对12.13%，双胎为28.0%对25.15%）。
在使用自体卵子受孕并活产的ART妊娠中，与新鲜胚胎移植相比，涉及冷冻复苏胚胎移植的妊娠发生有严重特征的子痫前期和早产子痫前期的风险增加。
