Reproductive Medical Center, the First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, Henan Province, 450052, People's Republic of China.
Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
BMC Pregnancy Childbirth. 2024 Sep 7;24(1):588. doi: 10.1186/s12884-024-06794-4.
The positive correlation between embryo quality and pregnancy outcomes has been confirmed in many studies, but there are few on the impact of embryo quality on neonatal weight, especially among neonates from fresh IVF‒ET cycles in ART. Therefore, this study aimed to compare the birth weights of infants from different blastocyst grades in fresh IVF-ET cycles and explore related factors affecting birth weight.
The main outcome measure was singleton birth weight. A total of 1301 fresh cycles of single blastocyst transplantation and single live birth profiles were retrospectively analyzed and divided into four groups according to blastocyst quality: the excellent group (grade AA), which included 170 cycles; the good group (grade AB/BA), which included 312 cycles; the average group (grade BB/CA/AC), which included 559 cycles; and the poor group (grade BC/CB), which included 260 cycles. The relationships among cystic cavity expansion, endocytic cell mass, ectodermal trophoblast cell grade, and birth weight were studied. Multiple linear regression analysis was performed to investigate the relationship between blastocyst quality and neonatal birth weight and logistic regression for the risk factors for low birth weight newborns.
With decreases in the blastocyst quality, including ICM, TE quality, and embryo expansion stage, birth weight declined, and Z scores correspondingly decreased. After adjusting for confounders, the average and poor groups (P = 0.01 and P = 0.001, respectively) and blastocysts with TE grade C (P = 0.022) resulted in singletons with lower birth weight. Additionally, the poor group and blastocysts with Grade C TEs had a greater chance of leading to low birth weight infants compared with the other groups.
Our findings indicated that excellent and good-grade blastocyst transplantation could achieve better pregnancy outcomes and that average and poor-grade blastocyst transplantation, especially with grade C TEs, were associated with single birth weight loss. No association was found between the embryo expansion stage or ICM quality and neonatal birth weight.
许多研究已经证实胚胎质量与妊娠结局之间呈正相关，但关于胚胎质量对新生儿体重的影响的研究较少，特别是在辅助生殖技术（ART）中的新鲜体外受精-胚胎移植（IVF-ET）周期中。因此，本研究旨在比较新鲜 IVF-ET 周期中不同囊胚等级的婴儿的出生体重，并探讨影响出生体重的相关因素。
主要观察指标为单胎出生体重。回顾性分析了 1301 例单囊胚移植和单活产的新鲜周期资料，根据囊胚质量分为 4 组：优质组（AA 级）170 个周期，良好组（AB/BA 级）312 个周期，一般组（BB/CA/AC 级）559 个周期，差级组（BC/CB 级）260 个周期。研究囊胚腔扩张、内细胞团质量、滋养外胚层细胞分级与出生体重的关系。采用多元线性回归分析探讨囊胚质量与新生儿出生体重的关系，采用 logistic 回归分析低出生体重儿的危险因素。
随着囊胚质量（包括 ICM、TE 质量和胚胎扩张阶段）的降低，出生体重下降，Z 评分相应降低。调整混杂因素后，一般组和差级组（P=0.01 和 P=0.001）以及 TE 级 C 的囊胚（P=0.022）导致单胎出生体重较低。此外，与其他组相比，差级组和 TE 级 C 的囊胚更有可能导致低出生体重儿。
我们的研究结果表明，优质和良好等级的囊胚移植可以获得更好的妊娠结局，而一般和差级的囊胚移植，特别是 TE 级 C 的囊胚，与单胎出生体重减轻有关。胚胎扩张阶段或 ICM 质量与新生儿出生体重之间无相关性。
