Impact of endometrial thickness and its combined effect with maternal age on singleton adverse neonatal outcomes in frozen–thawed embryo transfer cycles

BackgroundThin endometrial thickness (EMT) and advanced age are both common risk factors for adverse neonatal outcomes (ANOs). However, studies evaluating the impact of EMT and combined effect of EMT and age on ANOs remain scarce with conflicts.MethodA retrospective cohort study was conducted on 7,7...

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Main Authors: Jie Wang, Lina Gao, Qiaoyun Huang, Weihua Jiang, Linjun Chen, Shanshan Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2024.1430321/full
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author Jie Wang
Jie Wang
Lina Gao
Lina Gao
Qiaoyun Huang
Qiaoyun Huang
Weihua Jiang
Weihua Jiang
Linjun Chen
Linjun Chen
Shanshan Wang
Shanshan Wang
author_facet Jie Wang
Jie Wang
Lina Gao
Lina Gao
Qiaoyun Huang
Qiaoyun Huang
Weihua Jiang
Weihua Jiang
Linjun Chen
Linjun Chen
Shanshan Wang
Shanshan Wang
author_sort Jie Wang
collection DOAJ
description BackgroundThin endometrial thickness (EMT) and advanced age are both common risk factors for adverse neonatal outcomes (ANOs). However, studies evaluating the impact of EMT and combined effect of EMT and age on ANOs remain scarce with conflicts.MethodA retrospective cohort study was conducted on 7,715 singleton deliveries from frozen embryo transfer (FET) cycles between 2017 and 2021. The participants were categorized into four groups based on EMT quartiles (≤8.5, 8.6–9.5, 9.6–10.5, and >10.5 mm). The primary outcome was preterm birth (PTB), and the secondary outcome included early PTB (EPTB), small/large for gestational age (SGA/LGA), and low birth weight (LBW).ResultsBaseline characteristics were unevenly distributed across EMT groups. After adjusting for the confounders, EMT was found to be associated with the incidence of PTB (aOR 0.922, 95% CI 0.874–0.973, p = 0.003), EPTB (aOR 0.795, 95% CI 0.663–0.954, p = 0.014), LBW (aOR 0.886, 95% CI 0.796–0.986, p = 0.027), and LGA (aOR 1.038, 95% CI 1.004–1.074, p = 0.030). Furthermore, the rates of LBW in the group of EMT at 9.6–10.5 mm (aOR 0.551, 95% CI 0.339–0.895, p = 0.016) and >10.5 mm (aOR 0.536, 95% CI 0.332–0.865, p = 0.011) were lower compared to those with EMT ≤8.5 mm. Among women aged over 35, EMT of 9.6–10.5 mm was associated with a significantly lower incidence of LBW compared to thinner EMT, without increasing the risk of ANOs related to thicker EMT.ConclusionsOur study demonstrated the independent nonlinear impact of EMT on PTB, EPTB, LGA, and LBW. It provided new insights into the combined effects of EMT and age in FET cycles and offered valuable references for the clinical management and treatment strategies aimed at EMT.
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spelling doaj-art-f49e9e5959d842cf9b9ab8e14ffb70142025-01-14T05:10:22ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-01-011510.3389/fendo.2024.14303211430321Impact of endometrial thickness and its combined effect with maternal age on singleton adverse neonatal outcomes in frozen–thawed embryo transfer cyclesJie Wang0Jie Wang1Lina Gao2Lina Gao3Qiaoyun Huang4Qiaoyun Huang5Weihua Jiang6Weihua Jiang7Linjun Chen8Linjun Chen9Shanshan Wang10Shanshan Wang11Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, ChinaCenter for Molecular Reproductive Medicine, Nanjing University, Nanjing, ChinaCenter for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, ChinaCenter for Molecular Reproductive Medicine, Nanjing University, Nanjing, ChinaCenter for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, ChinaCenter for Molecular Reproductive Medicine, Nanjing University, Nanjing, ChinaCenter for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, ChinaCenter for Molecular Reproductive Medicine, Nanjing University, Nanjing, ChinaCenter for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, ChinaCenter for Molecular Reproductive Medicine, Nanjing University, Nanjing, ChinaCenter for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, ChinaCenter for Molecular Reproductive Medicine, Nanjing University, Nanjing, ChinaBackgroundThin endometrial thickness (EMT) and advanced age are both common risk factors for adverse neonatal outcomes (ANOs). However, studies evaluating the impact of EMT and combined effect of EMT and age on ANOs remain scarce with conflicts.MethodA retrospective cohort study was conducted on 7,715 singleton deliveries from frozen embryo transfer (FET) cycles between 2017 and 2021. The participants were categorized into four groups based on EMT quartiles (≤8.5, 8.6–9.5, 9.6–10.5, and >10.5 mm). The primary outcome was preterm birth (PTB), and the secondary outcome included early PTB (EPTB), small/large for gestational age (SGA/LGA), and low birth weight (LBW).ResultsBaseline characteristics were unevenly distributed across EMT groups. After adjusting for the confounders, EMT was found to be associated with the incidence of PTB (aOR 0.922, 95% CI 0.874–0.973, p = 0.003), EPTB (aOR 0.795, 95% CI 0.663–0.954, p = 0.014), LBW (aOR 0.886, 95% CI 0.796–0.986, p = 0.027), and LGA (aOR 1.038, 95% CI 1.004–1.074, p = 0.030). Furthermore, the rates of LBW in the group of EMT at 9.6–10.5 mm (aOR 0.551, 95% CI 0.339–0.895, p = 0.016) and >10.5 mm (aOR 0.536, 95% CI 0.332–0.865, p = 0.011) were lower compared to those with EMT ≤8.5 mm. Among women aged over 35, EMT of 9.6–10.5 mm was associated with a significantly lower incidence of LBW compared to thinner EMT, without increasing the risk of ANOs related to thicker EMT.ConclusionsOur study demonstrated the independent nonlinear impact of EMT on PTB, EPTB, LGA, and LBW. It provided new insights into the combined effects of EMT and age in FET cycles and offered valuable references for the clinical management and treatment strategies aimed at EMT.https://www.frontiersin.org/articles/10.3389/fendo.2024.1430321/fullfrozen-thawed embryo transfersingleton deliveryendometrial thicknessmaternal ageadverse neonatal outcomes
spellingShingle Jie Wang
Jie Wang
Lina Gao
Lina Gao
Qiaoyun Huang
Qiaoyun Huang
Weihua Jiang
Weihua Jiang
Linjun Chen
Linjun Chen
Shanshan Wang
Shanshan Wang
Impact of endometrial thickness and its combined effect with maternal age on singleton adverse neonatal outcomes in frozen–thawed embryo transfer cycles
Frontiers in Endocrinology
frozen-thawed embryo transfer
singleton delivery
endometrial thickness
maternal age
adverse neonatal outcomes
title Impact of endometrial thickness and its combined effect with maternal age on singleton adverse neonatal outcomes in frozen–thawed embryo transfer cycles
title_full Impact of endometrial thickness and its combined effect with maternal age on singleton adverse neonatal outcomes in frozen–thawed embryo transfer cycles
title_fullStr Impact of endometrial thickness and its combined effect with maternal age on singleton adverse neonatal outcomes in frozen–thawed embryo transfer cycles
title_full_unstemmed Impact of endometrial thickness and its combined effect with maternal age on singleton adverse neonatal outcomes in frozen–thawed embryo transfer cycles
title_short Impact of endometrial thickness and its combined effect with maternal age on singleton adverse neonatal outcomes in frozen–thawed embryo transfer cycles
title_sort impact of endometrial thickness and its combined effect with maternal age on singleton adverse neonatal outcomes in frozen thawed embryo transfer cycles
topic frozen-thawed embryo transfer
singleton delivery
endometrial thickness
maternal age
adverse neonatal outcomes
url https://www.frontiersin.org/articles/10.3389/fendo.2024.1430321/full
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