Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; School of Public Health, Beer-Sheva, Israel.
Reprod Biomed Online. 2021 Jan;42(1):207-216. doi: 10.1016/j.rbmo.2020.09.030. Epub 2020 Oct 6.
Are obstetric and perinatal complications associated with morphokinetic parameters of embryo development?
This proof-of-concept pilot study included a retrospective analysis of embryo morphokinetic parameters of 85 live births following day 5 single blastocyst transfer. Kinetic variables included time interval (hours) from time of pronuclei fading (tPNf) to: time of 2 cells (tPNf-t2), 9 cells (tPNf-t9), morula (tPNf-tM), start of blastulation (tPNf-tSB), full blastocyst (tPNf-tB) and expanded blastocyst (tPNf-tEB). Multivariable logistic models were used to calculate the risk of perinatal complications after adjustment for confounders.
The mean interval of tPNf-tSB was significantly longer for newborns with congenital anomalies compared with healthy newborns (79.49 ± 5.78 versus 71.7 ± 6.3, respectively, P = 0.01) and for embryos of women who had gestational diabetes mellitus compared with normoglycemic women (76.56 ± 7.55 versus 71.5 ± 6.13, respectively, P = 0.015). The mean interval of tPNf-t9 was significantly longer for low-birthweight newborns compared with normal weight (49.25 ± 5.54 versus 45.47 ± 4.77, respectively, P = 0.01). Preterm delivery was associated with several longer intervals of cell divisions compared with delivery at term (tPNf-t5: 28.76 ± 3.13 versus 26.64 ± 2.40, respectively, P = 0.01; tPNf-t6: 30.10 ± 3.05 versus 27.68 ± 2.30, respectively, P < 0.001; tPNf-t7: 32.08 ± 4.11 versus 28.70 ± 2.67, respectively, P < 0.001; tPNf-t8: 34.75 ± 4.95 versus 30.70 ± 4.10, respectively, P < 0.001; tPNf-t9: 50.23 ± 5.87 versus 45.44 ± 4.67, respectively, P < 0.001). For each of the outcomes, the association remained significant after adjusting for confounders.
This study indicates that there may be a possible association between adverse perinatal outcomes and morphokinetic parameters. Larger studies are needed to establish this association.
产科和围产期并发症是否与胚胎发育的形态动力学参数有关？
本概念验证性试点研究回顾性分析了 85 例第 5 天单囊胚移植后活产儿的胚胎形态动力学参数。动力学变量包括从原核消失（tPNf）到：2 细胞（tPNf-t2）、9 细胞（tPNf-t9）、桑椹胚（tPNf-tM）、囊胚孵化开始（tPNf-tSB）、完全囊胚（tPNf-tB）和扩展囊胚（tPNf-tEB）的时间间隔（小时）。使用多变量逻辑模型计算了在调整混杂因素后围产期并发症的风险。
与健康新生儿相比，先天性畸形新生儿的 tPNf-tSB 间隔时间明显较长（分别为 79.49 ± 5.78 小时和 71.7 ± 6.3 小时，P = 0.01），与血糖正常的女性相比，患有妊娠期糖尿病的女性胚胎的 tPNf-tSB 间隔时间也明显较长（分别为 76.56 ± 7.55 小时和 71.5 ± 6.13 小时，P = 0.015）。与正常体重新生儿相比，低体重儿的 tPNf-t9 间隔时间明显较长（分别为 49.25 ± 5.54 小时和 45.47 ± 4.77 小时，P = 0.01）。与足月分娩相比，早产与多个细胞分裂的间隔时间较长有关（tPNf-t5：28.76 ± 3.13 小时与 26.64 ± 2.40 小时，P = 0.01；tPNf-t6：30.10 ± 3.05 小时与 27.68 ± 2.30 小时，P < 0.001；tPNf-t7：32.08 ± 4.11 小时与 28.70 ± 2.67 小时，P < 0.001；tPNf-t8：34.75 ± 4.95 小时与 30.70 ± 4.10 小时，P < 0.001；tPNf-t9：50.23 ± 5.87 小时与 45.44 ± 4.67 小时，P < 0.001）。对于每个结果，在调整混杂因素后，相关性仍然显著。
本研究表明，围产期不良结局与形态动力学参数之间可能存在关联。需要更大的研究来确定这种关联。
