Fertilitat - Reproductive Medicine Center, Rua Gomes Jardim, 201 Torre Norte 15° andar, Santana, Porto Alegre, Rio Grande do Sul, 91530-001, Brazil.
School of Medicine, Pontifical Catholic University of Rio Grande do Sul, PUCRS, Av. Ipiranga, 6681, prédio 12A, Partenon, Porto Alegre, Rio Grande do Sul, 90619-900, Brazil.
BMC Pregnancy Childbirth. 2022 Jul 28;22(1):603. doi: 10.1186/s12884-022-04920-8.
In spontaneous pregnancies, maternal weight and gestational diabetes are independent risk factors for macrosomia and large-for-gestational-age newborns. Furthermore, maternal body mass index (BMI) of ≥25 kg/m is associated with worse neonatal vitality, classified as an Apgar score of < 7 at the fifth minute of life. However, few studies have evaluated the influence of BMI on perinatal outcomes in pregnancies resulting from assisted reproduction. Therefore, this study aimed to analyze whether the perinatal outcomes of assisted reproduction are influenced by BMI.
This was a retrospective cohort study performed at a reproductive medicine center. Patients undergoing assisted reproduction (2013-2020) were divided into three groups according to their BMI (kg/m): group 1, < 25; group 2, 25-29.9, and group 3, ≥30. In total, 1753 in vitro fertilization embryo transfer cycles were analyzed. Data were expressed as mean ± standard deviation or frequency (%). The analysis of variance and chi-square test were performed for comparison. To determine the participants and number of cycles for these analyses, generalized estimating equations were used, considering p < 0.05.
In groups 1, 2, and 3, the rates of live birth were 33.5, 32.3, and 29.9% (p = 0.668); preeclampsia were 2.9, 6.1, and 6.3% (p = 0.268); small-for-gestational-age newborns were 23, 23.2, and 21.7% (p = 0.965); macrosomia were 1.9, 0.9, and 2.7% (p = 0.708); Apgar score > 7 at the fifth minute were 97.6, 98.2, and 100% (p = 0.616); and preterm birth were 29.6, 30.1, and 35.1% (p = 0.970), respectively.
In conclusion, although the three groups had similar perinatal outcomes in this study, the study population was too small for conclusive results. The higher the BMI, the lower the chances of clinically relevant LBR and the higher the chances of premature labor and preeclampsia.
在自然妊娠中，母体体重和妊娠期糖尿病是巨大儿和大于胎龄儿的独立危险因素。此外，母体体重指数（BMI）≥25kg/m2 与新生儿活力较差相关，表现为第五分钟的 Apgar 评分<7 分。然而，很少有研究评估 BMI 对辅助生殖妊娠围产结局的影响。因此，本研究旨在分析辅助生殖的围产结局是否受 BMI 影响。
这是一项在生殖医学中心进行的回顾性队列研究。根据 BMI（kg/m2）将接受辅助生殖的患者（2013-2020 年）分为三组：组 1，<25；组 2，25-29.9；组 3，≥30。共分析了 1753 例体外受精胚胎移植周期。数据表示为均值±标准差或频率（%）。采用方差分析和卡方检验进行比较。为了确定这些分析的参与者和周期数量，使用广义估计方程进行分析，考虑 p<0.05。
在组 1、组 2 和组 3 中，活产率分别为 33.5%、32.3%和 29.9%（p=0.668）；子痫前期发生率分别为 2.9%、6.1%和 6.3%（p=0.268）；小于胎龄儿发生率分别为 23%、23.2%和 21.7%（p=0.965）；巨大儿发生率分别为 1.9%、0.9%和 2.7%（p=0.708）；第五分钟 Apgar 评分>7 分的比例分别为 97.6%、98.2%和 100%（p=0.616）；早产发生率分别为 29.6%、30.1%和 35.1%（p=0.970）。
综上所述，尽管本研究中三组的围产结局相似，但研究人群太小，无法得出明确的结论。BMI 越高，临床相关活产率的机会越低，早产和子痫前期的机会越高。
