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Effect of embryo stage at transfer on placental histopathology features in singleton live births resulting from fresh embryo transfers
Fertility and Sterility ( IF 6.7 ) Pub Date : 2020-07-01 , DOI: 10.1016/j.fertnstert.2020.06.017 Alexander Volodarsky-Perel 1 , Tuyet Nhung Ton Nu 2 , William Buckett 1 , Alexandre Machado-Gedeon 1 , Yiming Cui 1 , Jonathan Shaul 1 , Michael H Dahan 1
Fertility and Sterility ( IF 6.7 ) Pub Date : 2020-07-01 , DOI: 10.1016/j.fertnstert.2020.06.017 Alexander Volodarsky-Perel 1 , Tuyet Nhung Ton Nu 2 , William Buckett 1 , Alexandre Machado-Gedeon 1 , Yiming Cui 1 , Jonathan Shaul 1 , Michael H Dahan 1
Affiliation
OBJECTIVE
To evaluate the effect of embryo stage at transfer on placental histopathology and perinatal outcome in singleton live births resulting from fresh embryo transfers (ETs). DESIGN
Retrospective cohort study. SETTING
Not applicable. PATIENT(S)
The study population included all live births after fresh ETs during the period from 2009 to 2017. INTERVENTION(S)
None. MAIN OUTCOME MEASURE(S)
Primary outcomes included anatomic, inflammatory, vascular malperfusion, and villous maturation placental features. Secondary outcomes included fetal, maternal, and perinatal complications. RESULT(S)
A total of 677 live births were included in the final analysis and were allocated to the cleavage-stage (n = 252) and blastocyst (n = 425) ET groups. After the adjustment for confounding factors, the blastocyst group was found to be associated with a higher incidence of circummarginate membranes insertion (odds ratio [OR] 1.9, 95% confidence interval [CI] 1.2-3.4), delayed villous maturation (OR 8.5, 95% CI 1.2-69.3), chorangiosis (OR 2.0, 95% CI 1.2-3.8), parenchymal calcifications (OR 10.6, 95% CI 1.4-80.2), and intrapartum nonreassuring fetal heart rate tracing (OR 2.4, 95% CI 1.3-4.5). Compared with cleavage-stage ETs, live births resulting from the blastocysts were associated with a lower incidence of velamentous cord insertion (OR 0.5, 95% CI 0.3-0.9), retroplacental hematoma (OR 0.3, 95% CI 0.1-0.8), subchorionic thrombi (OR 0.3, 95% CI 0.1-0.8), and avascular villi (OR 0.2, 95% CI 0.03-0.7). CONCLUSION(S)
Live births resulting from fresh cleavage-stage and blastocyst ETs have different placental histopathology features, with a higher rate of intrapartum nonreassuring fetal heart rate tracing in the blastocyst group.
中文翻译：
移植时胚胎阶段对新鲜胚胎移植产生的单胎活产胎盘组织病理学特征的影响
目的 评估移植时胚胎阶段对新鲜胚胎移植 (ET) 单胎活产儿胎盘组织病理学和围产期结局的影响。设计 回顾性队列研究。设置 不适用。患者 研究人群包括 2009 年至 2017 年期间新鲜 ET 后的所有活产。 干预 无。主要结果测量主要结果包括解剖、炎症、血管灌注不良和胎盘绒毛成熟特征。次要结局包括胎儿、母体和围产期并发症。结果 共有 677 名活产婴儿被纳入最终分析，并被分配到卵裂期 (n = 252) 和囊胚 (n = 425) ET 组。调整混杂因素后，发现囊胚组与较高的外周膜插入发生率（比值比 [OR] 1.9，95% 置信区间 [CI] 1.2-3.4）、绒毛成熟延迟（OR 8.5，95% CI 1.2-69.3）相关, 绒毛膜病 (OR 2.0, 95% CI 1.2-3.8), 实质钙化 (OR 10.6, 95% CI 1.4-80.2) 和产时不可靠的胎心率追踪 (OR 2.4, 95% CI 1.3-4.5)。与卵裂期 ET 相比，由囊胚导致的活产与较低的丝状脐带插入 (OR 0.5, 95% CI 0.3-0.9)、胎盘后血肿 (OR 0.3, 95% CI 0.1-0.8)、绒毛膜下血肿的发生率相关血栓（OR 0.3，95% CI 0.1-0.8）和无血管绒毛（OR 0.2，95% CI 0.03-0.7）。结论 (S) 新鲜卵裂期和囊胚 ET 导致的活产具有不同的胎盘组织病理学特征，
更新日期：2020-07-01
中文翻译：
移植时胚胎阶段对新鲜胚胎移植产生的单胎活产胎盘组织病理学特征的影响
目的 评估移植时胚胎阶段对新鲜胚胎移植 (ET) 单胎活产儿胎盘组织病理学和围产期结局的影响。设计 回顾性队列研究。设置 不适用。患者 研究人群包括 2009 年至 2017 年期间新鲜 ET 后的所有活产。 干预 无。主要结果测量主要结果包括解剖、炎症、血管灌注不良和胎盘绒毛成熟特征。次要结局包括胎儿、母体和围产期并发症。结果 共有 677 名活产婴儿被纳入最终分析，并被分配到卵裂期 (n = 252) 和囊胚 (n = 425) ET 组。调整混杂因素后，发现囊胚组与较高的外周膜插入发生率（比值比 [OR] 1.9，95% 置信区间 [CI] 1.2-3.4）、绒毛成熟延迟（OR 8.5，95% CI 1.2-69.3）相关, 绒毛膜病 (OR 2.0, 95% CI 1.2-3.8), 实质钙化 (OR 10.6, 95% CI 1.4-80.2) 和产时不可靠的胎心率追踪 (OR 2.4, 95% CI 1.3-4.5)。与卵裂期 ET 相比，由囊胚导致的活产与较低的丝状脐带插入 (OR 0.5, 95% CI 0.3-0.9)、胎盘后血肿 (OR 0.3, 95% CI 0.1-0.8)、绒毛膜下血肿的发生率相关血栓（OR 0.3，95% CI 0.1-0.8）和无血管绒毛（OR 0.2，95% CI 0.03-0.7）。结论 (S) 新鲜卵裂期和囊胚 ET 导致的活产具有不同的胎盘组织病理学特征，
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