辅助生殖技术后低体重指数与异位妊娠相关：一项回顾性研究
【目的】
研究胚胎移植后体重指数和异位妊娠的相关性。
【设计】
回顾性队列研究。
【处所】
大学附属医院。
【人群】
自2008年1月至2017年12月共有16378名妇女接受新鲜胚胎或冰冻胚胎移植后受孕。
【方法】
鉴于一位妇女可能多次妊娠，我们利用广义估计方程（generalisedestimating equation，GEE）分析体重指数类型和异位妊娠的关系。同时利用广义估计方程证实非线性关系。模型经年龄、孕产次、前次异位妊娠史、不孕时长、多囊卵巢综合征、子宫内膜异位症、输卵管疾病、卵巢储备指标、卵巢刺激参数、受精方案、内膜厚度和胚胎移植方案校正。
【主要测量结局】
异位妊娠。
【结果】
参照WHO标准，每个周期不同BMI人数分别为低BMI（<18.5 kg/m2）2155，正常BMI（18.5–24.9 kg/m2）13447，高BMI（≥25 kg/m2）776。与正常BMI组相比，低BMI组的异位妊娠率显著增加（2.92% vs 2.02%，相对风险1.45, 95%CI1.11-1.90），但在高BMI组中未见差异（2.84%，相对风险1.41, 95% CI0.92–2.20）。校正混杂因素后，低BMI组与正常BMI组比较，异位妊娠比值比1.61 （95% CI 1.19–2.16）；与高BMI组相比的比值比1.12（95% CI 0.72–1.76）。
【结论】
低BMI与异位妊娠风险增加有关。
Low body mass index is associated with ectopic pregnancy followingassisted reproductive techniques: a retrospective study
JCai LLiu XJiang PLi ASha JRen
First published: 23 June 2020
https://doi.org/10.1111/1471-0528.16378
【Objective】
To investigate the association between bodymass index (BMI) and ectopic pregnancy (EP) following embryo transfer (ET).
【Design】
Retrospective cohort study.
【Setting】
University‐affiliated hospital.
【Population】
A total of 16 378 pregnancies derivedfrom either fresh ET or frozen–thawed ET between January 2008 and December.
【Methods】
We used the generalised estimating equation(GEE) to analyse the association between BMI categories and EP, as one womanmay contribute to more than one pregnancy. Generalised additive models werealso used to demonstrate the non‐linear association. Models were adjusted forage, parity, gravidity, previous history of ectopic pregnancy, duration ofinfertility, polycystic ovary syndrome, endometriosis, diagnosis of tubalproblems, ovarian reserve markers, ovarian stimulation parameters, inseminationprotocol, endometrial thickness and embryo transfer policies.
【Main outcome measures】
Ectopic pregnancy.
【Results】
According to the WHO criteria, the numberof cycles with low (<18.5 kg/m2), normal (18.5–24.9 kg/m2) andhigh (≥25 kg/m2) BMI were 2155, 13 447 and 776, respectively. Incomparison with the normal BMI group, the rate of EP was significantlyincreased in the low BMI group (2.92% versus 2.02%, relative risk 1.45, 95% CI1.11–1.90), but not in the high BMI group (2.84%, relative risk 1.41, 95% CI0.92–2.20). Adjusted for confounding factors, the odds ratio for EP comparinglow BMI versus normal BMI was 1.61 (95% CI 1.19–2.16) and that comparing highBMI versus normal BMI was 1.12 (95% CI 0.72–1.76).
【Conclusions】
Low BMI is associated with an increasedrisk of EP.
（编译 王伟琳）
