Impact of the type of endometrial oestrogen preparation for frozen-thawed embryo (vaginal or transdermal) on perinatal outcomes in an artificial cycle

Abstract STUDY QUESTION Does the endometrial preparation protocol for frozen embryo transfer (FET) have an impact on perinatal outcomes? SUMMARY ANSWER Singleton newborns from conceptions after an artificial FET cycle had a higher risk of being large for gestational age (LGA). WHAT IS KNOWN ALREADY Most previous studies have concentrated on the clinical pregnancy, miscarriage and live birth rates of different endometrial preparation protocols for FET. However, the impacts of these cycle regimens on perinatal outcomes including birthweight, gestational age (GA) and related outcomes require more investigation. STUDY DESIGN, SIZE, DURATION We retrospectively analysed all singletons conceived by women who underwent non-donor FET cycles between July 2014 and July 2017. The propensity score matching (PSM) method using nearest neighbour matching at a proportion of 1:1 was established to adjust for factors that influence the probability of receiving different FET cycle regimens. The main outcomes of the study included birthweight and its related outcomes, Z-score, low birthweight (LBW, <2500 g), small for gestational age (SGA, ≤10th percentile of referential birthweight), LGA (≥90th percentile of referential birthweight) and macrosomia (birthweight >4000 g). The study outcomes also included GA at birth, preterm delivery (<37 weeks), very preterm delivery (<32 weeks), very low birthweight (VLBW, <1500 g), term LBW (at 37 weeks of gestation or greater) and preterm LBW (at <37 weeks of gestation). PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 9267 cycles with live-born singletons were included in the analysis in our centre between July 2014 and July 2017. Of these, 2224, 4299 and 2744 live-born singletons were conceived by natural cycle FET, stimulated cycle FET and artificial cycle FET, respectively. After PSM, 1947 cycles of natural cycle FET versus stimulated cycle FET, 1682 cycles of stimulated cycle FET versus artificial cycle FET and 2333 cycles of natural cycle FET versus artificial cycle FET were included in the analysis. MAIN RESULTS AND THE ROLE OF CHANCE A higher mean birthweight and Z-score were observed in the artificial cycle FET group than in the stimulated cycle FET group (P = 0.005; P = 0.004, respectively). Singleton newborns conceived after artificial cycle FET were more likely to be LGA than those born after natural cycle FET or stimulated cycle FET (19.92% versus 16.94% and 19.29% versus 16.12%, respectively). The adjusted ORs (95% CIs) were 1.25 (1.05, 1.49) for artificial cycle FET compared with natural cycle FET (P = 0.014) and 1.26 (1.08, 1.46) for artificial cycle FET compared with stimulated cycle FET (P = 0.003). Newborns conceived after stimulated cycle FET had a lower mean GA at birth and a lower mean birthweight than those born after natural cycle FET or artificial cycle FET. The stimulated cycle FET group had lower adjusted odds of being macrosomia than the natural cycle FET group. No significant differences between natural cycle FET and stimulated cycle FET were found for any of the other outcomes. LIMITATIONS, REASONS FOR CAUTION This study had the disadvantage of being retrospective, and some cases were excluded due to missing data. The original allocation process was not randomized, which may have introduced bias. We have chosen not to account for multiple comparisons in our statistical analysis. WIDER IMPLICATIONS OF THE FINDINGS LGA can have long-term consequences in terms of risk for disease, which means that the influences of artificial cycle FET are of clinical significance and deserve more attention. Furthermore, these findings are critical for clinicians to be able to make an informed decision when choosing an endometrial preparation method. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by grants from the National Natural Science Foundation of China (NSFC) (31770989 to Y.W.) and the Shanghai Ninth People’s Hospital Foundation of China (JYLJ030 to Y.W.). None of the authors have any conflicts of interest to declare.

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Perinatal outcomes of intended vaginal breech births with epidural versus non-epidural analgesia

10.1055/s-0040-1717896 ◽

2020 ◽

Author(s):

R Allert ◽

L Jennewein ◽

N Bock ◽

D Brüggmann ◽

F Louwen

Keyword(s):

Epidural Analgesia ◽

Perinatal Outcomes

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Perinatal outcomes in Mexican women with mild gestational diabetes mellitus without treatment diagnosed by the international association of diabetes and pregnancy study groups criteria

Endocrine Abstracts ◽

10.1530/endoabs.56.p481 ◽

2018 ◽

Author(s):

Cruz Nayeli Martinez ◽

Munoz Enrique Reyes ◽

Ortega Karla P. Soriano ◽

Sanchez Lidia Arce ◽

Gonzalez Carlos Ortega ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

International Association ◽

Perinatal Outcomes ◽

Study Groups ◽

Mexican Women ◽

Diabetes And Pregnancy

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On the possibility of targeted prophylaxis of calcitriol-associated pregnancy complications at the preclinical stage

HEALTH OF WOMAN ◽

10.15574/hw.2020.150.43 ◽

2020 ◽

pp. 43-50

Author(s):

N.V. Didenkul ◽

Keyword(s):

Vitamin D ◽

Pregnancy Complications ◽

Comparison Group ◽

Reproductive Potential ◽

Perinatal Outcomes ◽

Fetal Distress ◽

Optimal Level ◽

Initial Study ◽

Management Plan ◽

Placental Dysfunction

According to recent studies, in the vitamin D deficiency state (VDD), pregnancy can be complicated and the optimal level of VD in the blood is one of the conditions for the realization of reproductive potential. The objective: the possibility to preventing calcitriol-associated pregnancy complications by the correcting VD deficiency at the preconception period. Materials and methods. 57 women with VDD were examined. A history of all women had a pregnancy complicated by placental dysfunction (PD); 27 of them were observed from the preconception period (main group – IA) and 30 – from the 1st trimester of pregnancy (comparison group – IB). The VD status by the blood level of the 25-hydroxyvitamin D by ELISA was determined. Women of both groups, in addition to the vitamin-mineral complex (VMC) were prescribed supplementation colecalciferol at a dose of 4.000 IU per day. Pregnant women of both groups received VMCs up to 16 weeks. After optimizing the level (3–4 months), women continued to take VD at a dose of 2.000 IU per day throughout pregnancy. Results. At the initial study, the VD level was 15.72±2.59 ng/ml in ІА and 16.1±1.99 ng/ml in ІВ group (U=883; p>0.05); after treatment increased to 38.31±3.29 ng/ml and 36.13±2.99 ng/ml (U=900; p>0.05). In group IA, the course of pregnancy was characterized by a lower frequency of complications: PD was diagnosed in 22.2% in group IA and 50% in group IB (F=0.0001; p<0.01); fetal distress in 3.7% and 10% (F=0.16; p<0.05): signs of amnionitis – in 18.5% and 33.3% (F=0.035; p<0.05); placental hypertrophy or hypotrophy – in 7.4% and 36.7% (F=0.00001; p<0.01), preeclampsia in 3.7% and 6.7% of women (F=0,54; p<0.05). The frequency of cesarean section in the comparison group was significantly higher (40% VS 25.9%, F=0.034; p<0.05). Conclusions. During pregnancy, which occurred in conditions of VDD, the frequency of some pregnancy complications, including preeclampsia, the threat of miscarriage, placental dysfunction was in 2–4 times higher than in women with optimized VD status. One of the directions of the individual management plan for women with a negative obstetric history can be the determination of the level of VD in the blood and correction of the VDD at the preconception period. This approach is a pathogenetically substantiated and promising direction for the prevention of some pregnancy complications and improvement of perinatal outcomes. Keywords: pregnancy, deficiency vitamin D, placental dysfunction, preconception period.

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Hydramnios In Singleton Pregnacies And Perinatal Outcomes

10.26226/morressier.59f838b6a874c6001b34e8ba ◽

2017 ◽

Author(s):

GEORGE STRATOUDAKIS

Keyword(s):

Perinatal Outcomes

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Vitamin D3 and women's health

GYNECOLOGY ◽

10.26442/20795696.2019.1.190235 ◽

2019 ◽

Vol 21 (1) ◽

pp. 44-51

Author(s):

Iuliia E Dobrokhotova ◽

Ekaterina I Borovkova ◽

Sofya A Zalesskaya ◽

Victoria S Skalnaya ◽

Ivan M Borovkov ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Vitamin D3 ◽

Negative Impact ◽

Perinatal Outcomes ◽

Hypovitaminosis D ◽

Malignant Neoplasms ◽

Cellular Functions ◽

Prophylactic Drug ◽

Drug Doses

Background. Vitamin D is an essential component that regulates calcium homeostasis and many other cellular functions. Hypovitaminosis D is associated with a risk of osteopenia, obesity, type 1 and type 2 diabetes, malignant neoplasms and immune disorders. Inadequate vitamin D intake during pregnancy increases a risk of pre-eclampsia, preterm birth, low birth weight as well as it has a negative impact on both children’s and adolescents’ health. It is important for the clinician to be known administrating of vitamin D prophylactic and therapeutic regimens according to serum 25(OH)D levels. Aim. To determine causes and effects of vitamin D deficiency and to elaborate ways of their correction. Materials and methods. To write this review a search for domestic and foreign publications in Russian and international search systems (PubMed, eLibrary, etc.) for the last 2-15 years was conducted. The review includes articles from peer-reviewed literature. Results. The article shows that vitamin D has a significant impact on both the cardiovascular, endocrine, digestive, respiratory and other systems functioning and perinatal outcomes that necessitates vitamin D deficiency correction. It provides schemes for effective therapeutic and prophylactic drug doses calculating depending on vitamin D3 blood serum concentration. Conclusion. Preference should be given to cholecalciferol (vitamin D3) due to its better absorption properties and more efficient conversion to active vitamin metabolites (class IIC).

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