Ovarian stimulation and low birth weight in newborns conceived through in vitro fertilization.
Ovarian stimulation and low birth weight in newborns conceived through in vitro fertilization.
复制标题
DOI：
10.1097/aog.0b013e31822be65f
复制
发表时间：
2011-10
影响因子：
7.2
通讯作者：
Barnhart KT
中科院分区：
文献类型：
--
作者：
Kalra SK;Ratcliffe SJ;Coutifaris C;Molinaro T;Barnhart KT
体外受精（IVF）后出生的单胎婴儿发生低出生体重（LBW）和/或早产的风险增加。我们试图评估由于卵巢刺激引起的围着床期母体环境的改变是否可能导致体外受精（IVF）分娩风险增加。辅助生殖技术协会数据库用于识别2004-2006年间在美国出生的IVF受孕婴儿。在卵巢反应性相似的妇女中，在新鲜胚胎移植与冷冻和解冻胚胎移植后出生的婴儿中，在同一妇女在两种类型的胚胎移植后出生的婴儿的配对分析中，以及在卵母细胞捐赠后出生的婴儿中，评估了相关性。在确定的56，792名婴儿中，分别有38，626名和18，166名是在移植新鲜和冷冻胚胎后受孕的。在单胎中，早产没有差异。然而，总体低出生体重（LBW）的几率（10% vs.7.2%; AOR 1.35，95% CI 1.20-1.51），足月时LBW（2.5% vs. 1.2%; AOR 1.73，95% CI 1.31-2.29）和早产LBW（34.1% vs. 23.8%; AOR 1.49，95% CI 1.24-1.78）在新鲜胚胎移植后均显著升高。在同一患者新鲜或冷冻胚胎移植后的单胎中，这种相关性甚至更强（LBW：[11.5% vs. 5.6%; AOR 4.66，95% CI 1.18 - 18.38，]）。在未接受任何卵巢激素刺激的新鲜或冷冻胚胎移植的卵母细胞供体受体中，LBW无差异（11.5% vs.11.3%; AOR 0.99，95%CI 0.82 - 1.18）。卵巢刺激诱导的母体环境似乎是IVF后受孕的婴儿中导致LBW风险的独立介质，但不是早产。
Singleton infants born after in-vitro fertilization (IVF) are at increased risk for low birth weight (LBW) and/or preterm delivery. We sought to assess if the alteration of the peri-implantation maternal environment due to ovarian stimulation may contribute to increased risk in in vitro fertilization (IVF) births. The Society of Assisted Reproductive Technology database was used to identify IVF-conceived infants born in the United States between 2004-2006. Associations were assessed in infants born after fresh compared with frozen and thawed embryo transfer in women of similar ovarian responsiveness, in paired analysis of infants born to the same woman following both types of embryo transfer, and in infants born following oocyte donation. Of 56,792 infants identified, 38,626 and 18,166 were conceived following transfer of fresh and frozen embryos, respectively. In singletons, there was no difference in preterm delivery. However, the odds of overall low birth weight (LBW) (10% vs.7.2%; AOR 1.35, 95% CI 1.20-1.51), LBW at term (2.5% vs. 1.2%; AOR 1.73, 95% CI 1.31-2.29), and preterm LBW (34.1% vs. 23.8%; AOR 1.49, 95% CI 1.24-1.78) were all significantly higher following fresh embryo transfer. In singletons following either fresh or frozen embryo transfer in the same patient, this association was even stronger (LBW: [11.5% vs. 5.6%; AOR 4.66, 95% CI 1.18 – 18.38,). In oocyte donor recipients who do not undergo any ovarian hormonal stimulation for either a fresh or a frozen embryo transfer, no difference in LBW was demonstrated (11.5% vs.11.3%; AOR 0.99, 95% CI 0.82 – 1.18). The ovarian stimulation-induced maternal environment appears to represent an independent mediator contributing to the risk of LBW, but not preterm delivery, in infants conceived following IVF.