Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
David Geffen School of Medicine, University of California, 8635 West Third Street, Suite 160W, Los Angeles, CA, 90048, USA.
J Assist Reprod Genet. 2018 Jun;35(6):1039-1046. doi: 10.1007/s10815-018-1176-7. Epub 2018 Apr 10.
Ratio of fetal weight to placenta size varies by mode of conception (fertility treatments utilized) in animals. Our objective was to assess whether fertility treatments also affect these ratios in humans.
In this retrospective study, we assessed two cohorts: (a) early gestation cohort, women with singleton pregnancies who underwent first trimester vaginal ultrasound and (b) delivered cohort, women who delivered a live-born, singleton infant with placenta disposition to pathology. Crown rump length (CRL) and estimated placental volume (EPV) were calculated from first trimester ultrasound images using a validated computation. Infant birth weight (BW), pregnancy data, placental weight (PW), and placental histopathology were collected. Fetal growth-to-placental weight ratios (CRL/EPV; BW/PW) and placentas were compared by mode of conception. Linear regression was used to adjust for confounding variables.
Two thousand one hundred seventy patients were included in the early gestation cohort and 1443 in the delivered cohort. Of the early gestation cohort (a), 85.4% were spontaneous conceptions, 5.9% Non-IVF Fertility (NIFT), and 8.7% IVF. In the delivered cohort (b), 92.4% were spontaneous, 2.1% NIFT, and 80 5.5% IVF. There were no significant differences between fetal growth-to-placental weight parameters, ratios, and neonatal birth measurements based on mode of conception. Placenta accreta was significantly higher in the patients receiving fertility treatments (1.2 versus 3.6%, p < 0.05).
Mode of conception does not appear to influence fetal growth-to-placental weight ratios throughout gestation. In addition, findings in animal models may not always translate into human studies of infertility treatment outcomes.
动物中，胎儿体重与胎盘大小的比例因受孕方式（所采用的生育治疗方法）而异。我们的目的是评估生育治疗是否也会影响人类的这些比例。
在这项回顾性研究中，我们评估了两个队列：（a）早期妊娠队列，接受过首次妊娠阴道超声检查的单胎妊娠妇女；（b）分娩队列，分娩出有胎盘位置病变的单胎活产婴儿的妇女。通过使用经验证的计算方法，从首次妊娠超声图像中计算头臀长（CRL）和估计胎盘体积（EPV）。收集婴儿出生体重（BW）、妊娠数据、胎盘重量（PW）和胎盘组织病理学。比较受孕方式的胎儿生长与胎盘重量比（CRL/EPV；BW/PW）和胎盘。使用线性回归调整混杂变量。
共有 2170 名患者纳入早期妊娠队列，1443 名患者纳入分娩队列。早期妊娠队列（a）中，85.4%为自然受孕，5.9%为非 IVF 生育（NIFT），8.7%为 IVF。分娩队列（b）中，92.4%为自然受孕，2.1%为 NIFT，80.5%为 IVF。受孕方式不同，胎儿生长与胎盘重量参数、比值和新生儿出生测量值无显著差异。接受生育治疗的患者胎盘植入的发生率明显更高（1.2%比 3.6%，p<0.05）。
在整个孕期，受孕方式似乎并不影响胎儿生长与胎盘重量的比例。此外，动物模型中的发现并不总是能转化为对不孕治疗结果的人类研究。
