目的:探讨替代方案冻胚移植(HRT-FET)周期中患者补充孕激素前的雌激素水平对妊娠期高血压疾病(HDP)发生的影响.方法:回顾分析 2017 年 5 月至 2022 年5 月于山东大学生殖医学中心经HRT-FET获单胎活产的3506 例患者的临床资料.根据E2 水平将患者分成 3 组:组 1(E2≤137pg/mL,≤25%,866 例),组 2(137pg/mL<E2≤240pg/mL,25.01%～75%,1806 例),组3(E2>240pg/mL,>75%,834 例).比较3 组患者的妊娠期并发症及新生儿结局.结果:组 3 患者的 HDP 发生率明显高于组 1(aOR = 0.653,95%CI 为 0.463～0.920,P = 0.015)及组 2(aOR = 0.750,95%CI 为 0.566～0.994,P=0.045).各组间妊娠期糖尿病、前置胎盘、产后出血等妊娠期并发症及早产、过期产、SGA(小于胎龄儿)、LGA(大于胎龄儿)等新生儿不良结局发生率无显著差异.结论:替代方案冻胚移植周期中转化内膜前的高雌激素水平是妊娠期高血压疾病发生的独立风险因素.
Objective:To explore the effect of serum estrogen level(E2)prior to pro-gesterone administration on incidence of hypertensive disorders of pregnancy(HDP)in single-tons born after frozen embryo transfer(FET)using hormone replacement therapy(HRT)cy-cles.Method:This retrospective study included 3506 singletons after HRT-FET from May 2017 to May 2022.Patients were divided into 3 groups according to the serum E2 levels before endo-metrial transformation:Group 1(E2≤137pg/mL),Group 2(137pg/mL<E2≤240pg/mL),Group3(E2>240pg/mL).The incidence of obstetric complications and perinatal outcomes were compared among groups.Results:The incidence of HDP was statistically increased in Group 3 compared with Group 1(aOR=0.653,95%CI 0.463～0.920,P=0.015)and Group 2(aOR= 0.750,95%CI 0.566～0.994,P=0.045).The incidences of gestational diabetes mellitus,pla-centa previa,postpartum hemorrhage,preterm labor,post-term labor,large for gestational age(LGA),small for gestational age(SGA)were comparable among groups.Conclusion:High E2 level was an independent risk factor for HDP in patients with singletons born after HRT-FET.
鲁娟娟;邵雨菡;张倩;倪天翔;王泽;李敬;颜军昊
山东大学生殖医学中心 国家辅助生殖技术和生殖遗传学研究中心 山东大学生殖内分泌教育部重点实验室,济南 250021山东大学生殖医学中心 国家辅助生殖技术和生殖遗传学研究中心 山东大学生殖内分泌教育部重点实验室,济南 250021||山东大学齐鲁医学院,济南 250000
基础医学
激素替代疗法;冻胚移植;雌二醇;妊娠期高血压疾病
Hormone replacement therapy;Frozen embryo transfer;Serum estrogen level;Hypertensive disorders of pregnancy
《现代妇产科进展》 2024 (001)
37-40,46 / 5
国家重点研发计划(No:2021YFC2700604);山东省重点研发计划(No:2021LCZX02)
10.13283/j.cnki.xdfckjz.2024.01.007
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