Association of parental prepregnancy BMI with neonatal outcomes and birth defect in fresh embryo transfer cycles: a retrospective cohort study.
Association of parental prepregnancy BMI with neonatal outcomes and birth defect in fresh embryo transfer cycles: a retrospective cohort study.
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父母孕前体重指数与新鲜胚胎移植周期中新生儿结局和出生缺陷的关系：一项回顾性队列研究
DOI：
10.1186/s12884-021-04261-y
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发表时间：
2021-11-27
影响因子：
3.1
通讯作者：
Zhang D
中科院分区：
文献类型：
--
作者：
Chen R;Chen L;Liu Y;Wang F;Wang S;Huang Y;Hu KL;Fan Y;Liu R;Zhang R;Zhang D
父母体重指数（BMI）与妊娠结局有关。但父母孕前体重指数对通过体外受精（IVF）或胞浆内单精子注射（ICSI）受孕的后代的影响，特别是出生缺陷的影响仍有待确定。本研究旨在探讨父母孕前体重指数与新鲜胚胎移植周期新生儿结局和出生缺陷的关系。方法对2013年1月至2016年7月浙江大学医学院附属女子医院首次IVF/ICSI周期的5741对夫妇进行回顾性队列研究。主要结局为出生缺陷，根据《国际疾病分类》第十版进行分类。次要结局包括早产率、婴儿性别、出生体重、小胎龄（SGA）和大胎龄（LGA）。采用多水平回归分析评估父母孕前BMI与新生儿结局和出生缺陷的关系。结果孕前BMI≥25 kg/m2的夫妇发生LGA的几率高于BMI < 25 kg/m2的夫妇。当IVF周期中父亲孕前BMI≥25 kg/m2 （aOR 1.82, 95% CI 1.06-3.10）和ICSI周期中母亲BMI≥25 kg/m2 （aOR 4.89, 95% CI 1.45-16.53）时，出生缺缺率显著升高。对于出生缺陷的亚类别，在父亲BMI≥25 kg/m2的试管婴儿后代中，只有肌肉骨骼系统先天性畸形的几率显著增加（aOR 4.55, 95% CI 1.32-15.71）。对于双胞胎，除了试管婴儿女婴出生体重较低外，四组间无显著差异。结论父母孕前BMI≥25 kg/m2与IVF/ICSI单胎LGA发生率增高有关。父亲孕前体重指数≥25 kg/m2的试管婴儿后代出生缺陷的风险可能高于BMI < 25 kg/m2的，特别是在肌肉骨骼系统。对于超重或肥胖夫妇来说，在试管婴儿/ICSI治疗前减肥是至关重要的。
BackgroundParental body mass index (BMI) is associated with pregnancy outcomes. But the effect of parental prepregnancy BMI on offspring conceived via in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), especially the birth defect, remains to be determined. This study aimed to investigate the associations of parental prepregnancy BMI with neonatal outcomes and birth defect in fresh embryo transfer cycles.MethodsWe conducted a retrospective cohort study including 5741 couples in their first fresh IVF/ICSI cycles admitted to Women’s Hospital, School of Medicine, Zhejiang University from January 2013 to July 2016. The primary outcome was birth defects, which was classified according to the International Classification of Diseases, 10th Revision. Secondary outcomes included preterm delivery rate, infant gender, birth weight, small-for-gestational age (SGA) and large-for-gestational age (LGA). Multilevel regression analyses were used to assess the associations of parental prepregnancy BMI with neonatal outcomes and birth defect.ResultsIn singletons, couples with prepregnancy BMI ≥25 kg/m2had higher odds of LGA than those with BMI < 25 kg/m2. The birth defect rate was significantly higher when paternal prepregnancy BMI ≥25 kg/m2in IVF cycles (aOR 1.82, 95% CI 1.06–3.10) and maternal BMI ≥25 kg/m2in ICSI cycles (aOR 4.89, 95% CI 1.45–16.53). For subcategories of birth defects, only the odds of congenital malformations of musculoskeletal system was significantly increased in IVF offspring with paternal BMI ≥25 kg/m2(aOR 4.55, 95% CI 1.32–15.71). For twins, there was no significant difference among four groups, except for the lower birth weight of IVF female infants.ConclusionsParental prepregnancy BMI ≥25 kg/m2is associated with higher incidence of LGA in IVF/ICSI singletons. Paternal prepregnancy BMI ≥25 kg/m2was likely to have higher risk of birth defect in IVF offspring than those with BMI < 25 kg/m2, particularly in the musculoskeletal system. It is essential for overweight or obesity couples to lose weight before IVF/ICSI treatments.
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