Sheba Medical Center at Tel Hashomer, Ramat Gan, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Reprod Sci. 2023 Jul;30(7):2275-2282. doi: 10.1007/s43032-023-01179-y. Epub 2023 Feb 2.
The aim of this study was to evaluate the effect of parity (primipara vs multipara) on the histopathology of the placenta in singleton live births following in vitro fertilization. We conducted a retrospective cohort study evaluating data of all IVF resulted live births from one university affiliated hospital during 2009-2017. All patients had the placenta sent for pathological evaluation. Exclusion criteria were history of miscarriage or elective termination of pregnancy, abnormal uterine cavity findings, previous uterine surgery, in vitro maturation cycles, gestational carrier cycles, oocyte recipient cycles, preimplantation genetic diagnosis cycles, and multiple pregnancies. The outcomes measured included anatomical, inflammation, vascular malperfusion, and villous maturation placental features. A multivariate analysis was conducted to adjust the results for factors potentially associated with placental pathology features. A total of 395 live births were included in the final analysis and were allocated to the study groups according to parity: primipara (n = 273) and multipara (n = 122). After adjustment for potential confounding factors, multiparity was found to be significantly associated with delayed villous maturation (OR 4.9; 95% CI 1.2-19.8) and primiparity was significantly associated with maternal vascular malperfusion (OR 0.6; 95% CI 0.3-0.8). We showed that parity has an impact on placental histopathological changes which in turn may affect perinatal outcome.
本研究旨在评估体外受精后单胎活产儿的产次(初产妇与经产妇)对胎盘组织病理学的影响。我们进行了一项回顾性队列研究,评估了 2009 年至 2017 年期间一家大学附属医院所有 IVF 活产儿的数据。所有患者的胎盘均进行了病理评估。排除标准为流产史或选择性终止妊娠史、子宫腔异常、既往子宫手术史、体外成熟周期、妊娠代孕周期、卵母细胞受者周期、着床前遗传学诊断周期和多胎妊娠。测量的结果包括胎盘的解剖学、炎症、血管灌注不良和绒毛成熟特征。进行了多变量分析,以调整与胎盘病理特征相关的潜在因素的结果。共有 395 例活产儿纳入最终分析,并根据产次分为研究组:初产妇(n=273)和经产妇(n=122)。在调整潜在混杂因素后,发现经产妇与绒毛成熟延迟显著相关(OR 4.9;95%CI 1.2-19.8),初产妇与母体血管灌注不良显著相关(OR 0.6;95%CI 0.3-0.8)。我们表明,产次对胎盘组织病理学变化有影响,进而可能影响围产期结局。