Effect of in vitro culture period on birth weight after vitrified-warmed transfer cycles: analysis of 4,201 singleton newborns
Effect of in vitro culture period on birth weight after vitrified-warmed transfer cycles: analysis of 4,201 singleton newborns
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玻璃化保温移植周期后体外培养期对出生体重的影响：4,201 名单胎新生儿的分析
DOI：
10.1016/j.fertnstert.2018.10.006
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发表时间：
2019-01-01
影响因子：
6.7
通讯作者：
Kuang, Yanping
中科院分区：
文献类型：
--
作者：
Zhang, Jie;Wang, Yun;Kuang, Yanping
目的：探讨玻璃化温控周期中胚胎培养时间对新生儿出生体重的影响。设计：回顾性队列研究。地点：三级保健学术医学中心。患者(S)：4,201例卵裂期(第3天)、第5天和第6天胚胎移植后分别产下3,520个，215个和466个活体单胎。干预(S)：无。主要结局(S)：新生儿出生体重。结果(S)：三个研究组的平均出生体重没有差异。然而，移植第5天和第6天后，单胎的胎龄和性别调整出生体重(Z-Score)和大胎龄(LGA)婴儿的比例显著高于移植第3天胚胎后。多元线性回归分析显示，胎龄、双亲体重指数、新生儿性别、培养时间长短均对单胎新生儿出生体重有显著影响。结论(S)：在玻璃化温控移植周期中，单胎胚胎移植后的新生儿出生体重Z值和低出生体重儿比例均高于卵裂期胚胎移植后的新生儿。这一发现表明，将胚胎移植到更具生理性的子宫环境中并不能克服培养时间的影响。(C)2018年，由美国生殖医学学会主办。
Objective: To investigate the effect of embryo culture duration on birth weight in vitrified-warmed cycles.Design: Retrospective cohort study.Setting: Tertiary-care academic medical center.Patient(s): A total of 4,201 women who gave birth to 3,520, 215, and 466 live-born singletons after frozen-thawed cleavage-stage (day 3) and day 5 and day 6 blastocyst transfer, respectively.Intervention(s): None.Main Outcome Measure(s): Neonatal birth weight.Result(s): The mean birth weight did not differ between the three study groups. However, the gestational age-and sex-adjusted birth weight (Z-scores) of singletons and the proportion of large-for-gestational-age (LGA) babies were significantly higher after day 5 and day 6 transfer than after transfer of day 3 embryos. Furthermore, multiple linear regression analysis indicated that gestational age, parental body mass index, neonatal sex, and length of the culture period all had significant and strong impacts on birth weight of singleton newborns.Conclusion(s): In the vitrified-warmed transfer cycles, birth weight Z-scores and the proportion of LGA infants were both higher in singletons born after blastocyst transfer than after transfer of cleavage-stage embryos. This finding suggests that the effect of culture duration was not overcome by transfer of embryos into a more physiologic uterine environment. (C) 2018 by American Society for Reproductive Medicine.