Associations between dyslipidaemia and pregnancy outcomes in the first complete cycle of IVF/ICSI: a real-world analysis
Associations between dyslipidaemia and pregnancy outcomes in the first complete cycle of IVF/ICSI: a real-world analysis
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第一个完整 IVF/ICSI 周期中血脂异常与妊娠结局之间的关联：真实世界分析
DOI：
10.1016/j.rbmo.2021.08.030
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发表时间：
2021-12-01
影响因子：
4
通讯作者：
Li, Yanping
中科院分区：
文献类型：
--
作者：
Yang, Tianli;Zhao, Jing;Li, Yanping
研究问题：在IVF/胞浆内单精子注射（ICSI）的第一个完整周期中，血脂异常与妊娠结局之间是否存在关联？设计：这项长期、回顾性的现实世界分析涉及5030名不孕妇女，她们在2015年1月至2020年10月期间接受了第一次完整的体外受精/ICSI周期。根据卵巢刺激前血清脂质浓度分为血脂异常组（n = 1903）和对照组（n = 3127）。采用倾向评分匹配和多变量逻辑回归控制混杂变量。结果：在原始队列中，与非血脂异常的妇女相比，患有血脂异常的妇女晚期流产率显著增加（P = 0.039），足月出生率显著降低（P = 0.002），活产率显著降低（P = 0.005）。在倾向评分匹配的队列中，血脂异常组（n = 1686）的足月出生率（P = 0.038）和活产率（P = 0.044）显著低于对照组（n = 1686）。多变量logistic回归显示，伴有血脂异常（P = 0.026）和血清总胆固醇浓度升高（总胆固醇5.20 mmol/l, P = 0.028）的不孕妇女活产的可能性显著降低。血脂浓度正常、交界性增高和增高妇女的晚期流产率（P = 0.027）、足月分娩率（P = 0.003）和活产率（P = 0.010）差异显著。与对照组相比，血清脂质浓度增高的妇女晚期流产率、足月出生率和活产率明显增高。血清脂质浓度升高的妇女与对照组相比，活产的可能性明显降低。结论：血脂异常、总胆固醇5.20 mmol/l和血脂浓度升高程度与不孕妇女第一次IVF/ICSI周期的活产率呈负相关。
Research question: Are there associations between dyslipidaemia and pregnancy outcomes in the first complete cycle of IVF/intracytoplasmic sperm injection (ICSI)? Design: This long-term, retrospective real-world analysis involved 5030 infertile women who underwent a first complete IVF/ICSI cycle between January 2015 and October 2020. They were categorized into dyslipidaemia (n = 1903) and control (n = 3127) groups according to serum lipid concentrations before ovarian stimulation. Propensity score matching and multivariable logistic regression were used to control for confounding variables. Results: In the raw cohort, women with dyslipidaemia had a significantly increased late miscarriage rate (P = 0.039), decreased term birth rate (P = 0.002) and decreased live birth rate (P = 0.005) compared with non-dyslipidaemic women. In the propensity score-matched cohort, the term birth rate (P = 0.038) and live birth rate (P = 0.044) were significantly lower in the dyslipidaemia group (n = 1686) than the controls (n = 1686). Multivariable logistic regression indicated that infertile women with dyslipidaemia (P = 0.026) and elevated serum total cholesterol concentrations (total cholesterol .5.20 mmol/l; P = 0.028) were significantly less likely to have a live birth. Rates of late miscarriage (P = 0.027), term birth (P = 0.003) and live birth (P = 0.010) differed significantly among women with normal, borderline increased and increased serum lipid concentrations. Compared with controls, women with increased serum lipid concentrations had a significantly higher late miscarriage rate, lower term birth rate and lower live birth rate. Women with increased serum lipid concentrations were significantly less likely than controls to have a live birth. Conclusions: Dyslipidaemia, total cholesterol .5.20 mmol/l and degrees of elevated serum lipid concentrations are negatively associated with live birth rate in the first complete IVF/ICSI cycle in infertile women.