Institute of Reproductive and Stem Cell Engineering, School of Basic Medicine, Central South University, Changsha, China.
Key Laboratory of Reproductive and Stem Cell Engineering, National Health and Family Planning Commission, Beijing, China.
Arch Gynecol Obstet. 2019 Nov;300(5):1227-1237. doi: 10.1007/s00404-019-05295-6. Epub 2019 Sep 24.
To determine whether the endometrial thickness (EMT) affects the occurrence of obstetric complications and neonatal outcomes in frozen embryo transfer (FET).
We conducted a retrospective study that included singleton deliveries (N = 5251) resulting from FET in a single center between August 2013 and March 2016. Obstetric complications and neonatal outcomes were compared among patients with different EMTs, which were measured the day before embryo thawing. The women were divided into three groups based on the EMT: group 1: < 9 mm; group 2: 9-12 mm; group 3: > 12 mm. Multiple logistic regression and subgroup analyses were performed to determine the potential confounding factors.
The incidence of placenta previa in groups 1, 2, and 3 was 3.8, 1.0 and 0.5%, respectively, and that of cesarean section was 87.0, 78.3 and 72.0%, respectively (both P < 0.001). The gestational age and birth weight increased from group 1 to group 3 (both P < 0.001). After adjusting for confounders, a thicker EMT was found to be associated with a decreased risk of placenta previa (adjusted odds ratio (aOR) 0.798; 95% confidence interval (95% CI) 0.651-0.979; P = 0.031) and with a decreased risk of cesarean section (aOR 0.926; 95% CI 0.889-0.965; P < 0.001). Regarding the incidence of placenta previa, compared to women in group 3, women in group 1 had an aOR of 6.208 (95% CI 2.169-17.766; P = 0.001), and women in group 2 had an aOR of 1.862 (95% CI 0.851-4.076; P = 0.120). Regarding the incidence of cesarean section, compared to women in group 3, women in group 1 had an aOR of 2.111 (95% CI 1.415-3.455; P < 0.001), and women in group 2 had an aOR of 1.293 (95% CI 1.128-1.481; P < 0.001). Subgroup analyses showed similar results.
Our results demonstrate that a thin endometrial lining is associated with adverse obstetric and neonatal outcomes and might be related to poor placentation.
探讨子宫内膜厚度（EMT）对冻融胚胎移植（FET）中产科并发症和新生儿结局的影响。
我们进行了一项回顾性研究，纳入了 2013 年 8 月至 2016 年 3 月期间在一家中心进行 FET 的单胎分娩（N=5251）。比较了不同 EMT 患者的产科并发症和新生儿结局，EMT 是在胚胎解冻前一天测量的。根据 EMT 将患者分为三组：组 1：<9mm；组 2：9-12mm；组 3：>12mm。采用多因素逻辑回归和亚组分析确定潜在的混杂因素。
组 1、组 2 和组 3 的前置胎盘发生率分别为 3.8%、1.0%和 0.5%，剖宫产率分别为 87.0%、78.3%和 72.0%（均 P<0.001）。组 1 到组 3 的胎龄和出生体重逐渐增加（均 P<0.001）。校正混杂因素后，发现 EMT 较厚与较低的前置胎盘风险相关（校正优势比（aOR）0.798；95%置信区间（95%CI）0.651-0.979；P=0.031）和较低的剖宫产风险相关（aOR 0.926；95%CI 0.889-0.965；P<0.001）。关于前置胎盘的发生率，与组 3 相比，组 1 的 aOR 为 6.208（95%CI 2.169-17.766；P=0.001），组 2 的 aOR 为 1.862（95%CI 0.851-4.076；P=0.120）。关于剖宫产的发生率，与组 3 相比，组 1 的 aOR 为 2.111（95%CI 1.415-3.455；P<0.001），组 2 的 aOR 为 1.293（95%CI 1.128-1.481；P<0.001）。亚组分析结果相似。
我们的结果表明，薄的子宫内膜与不良的产科和新生儿结局相关，可能与不良的胎盘形成有关。
Zotero 插件