Table 4.
Cumulative Obstetric and Perinatal Outcomes (Intention-to-Treat Analysis)
| Outcomes, No./total (%) | Blastocyst-stage embryo transfer group (n = 497) | Cleavage-stage embryo transfer group (n = 495) | Absolute differencea(95% CI) | Relative risk (95% CI) | P value |
|---|---|---|---|---|---|
| Live births outcomes | |||||
| Gestational age, mean (SD), weeks | 38.8 (1.7) | 38.9 (1.7) | −0.1 (−0.4 to 0.1) | - | 0.40 |
| Birthweight, mean (SD), grams | |||||
| Singleton | |||||
| No of observations | 363 | 324 | |||
| Mean weight | 3357.6 (505.0) | 3333.7 (526.5) | 23.9 (−53.4 to 101.2) | - | 0.54 |
| Twin | |||||
| No of observations | 18 | 8 | |||
| Mean weight | 2388.3 (650.5) | 2088.8 (622.6) | 299.6 (−263.9 to 863.0) | - | 0.28 |
| Low birth weightb | 18 (3.6) | 18 (3.6) | −0.0 (−2.3 to 2.3) | 1.00 (0.52 to 1.89) | 0.99 |
| Very low birth weightc | 5 (1.0) | 4 (0.8) | 0.2 (−1.0 to 1.4) | 1.24 (0.34 to 4.61) | 1.00 |
| Macrosomiad | 33 (6.6) | 36 (7.3) | −0.6 (−3.8 to 2.5) | 0.91 (0.58 to 1.44) | 0.70 |
| Small for gestational agee | 23 (4.6) | 20 (4.0) | 0.6 (−1.9 to 3.1) | 1.15 (0.64 to 2.06) | 0.65 |
| Large for gestational agef | 63 (12.7) | 54 (10.9) | 1.8 (−2.2 to 5.8) | 1.16 (0.83 to 1.63) | 0.39 |
| Sex ratio | |||||
| Male | 206/381(54.1) | 164/332(49.4) | 4.7 (−2.7 to 12.0) | 1.09 (0.95 to 1.26) | 0.21 |
| Female | 175/381(45.9) | 168/332(50.6) | |||
| Live birth without a complication | 130 (26.2) | 118 (23.8) | 2.3 (−3.1 to 7.7) | 1.10 (0.88 to 1.36) | 0.40 |
| Maternal complications | |||||
| Gestational diabetes mellitus | 54 (10.9) | 55 (11.1) | −0.2 (−4.1 to 3.6) | 0.98 (0.69 to 1.39) | 0.90 |
| Preeclampsia or eclampsia | 5 (1.0) | 14 (2.8) | −1.8 (−3.5 to −0.1) | 0.36 (0.13 to 0.98) | 0.04 |
| Gestational hypertension | 20 (4.0) | 17 (3.4) | 0.6 (−1.8 to 2.9) | 1.17 (0.62 to 2.21) | 0.62 |
| Preterm premature rupture of membraneg | 25 (5.0) | 8 (1.6) | 3.4 (1.2 to 5.6) | 3.11 (1.42 to 6.83) | 0.003 |
| Premature rupture of membrane | 51 (10.3) | 37 (7.5) | 2.8 (−0.7 to 6.3) | 1.37 (0.92 to 2.06) | 0.12 |
| Preterm birthh | 30 (6.0) | 18 (3.6) | 2.4 (−0.3 to 5.1) | 1.66 (0.94 to 2.94) | 0.08 |
| Spontaneous preterm birthi | 23 (4.6) | 10 (2.0) | 2.6 (0.4 to 4.8) | 2.29 (1.10 to 4.76) | 0.02 |
| Iatrogenic preterm birthj | 7 (1.4) | 8 (1.6) | −0.2 (−1.7 to 1.3) | 0.87 (0.32 to 2.38) | 0.79 |
| Very preterm birth ( < 32 Weeks)k | 5 (1.0) | 4 (0.8) | 0.2 (−1.0 to 1.4) | 1.24 (0.34 to 4.61) | 1.00 |
| Placenta previa | 8 (1.6) | 2 (0.4) | 1.2 (−0.0 to 2.4) | 3.98 (0.85 to 18.67) | 0.11 |
| Placental abruption | 3 (0.6) | 2 (0.4) | 0.2 (−0.7 to 1.1) | 1.49 (0.25 to 8.90) | 1.00 |
| Placental accreta | 12 (2.4) | 6 (1.2) | 1.2 (−0.5 to 2.9) | 1.99 (0.75 to 5.27) | 0.16 |
| Other placental abnormality | 11 (2.2) | 8 (1.6) | 0.6 (−1.1 to 2.3) | 1.37 (0.56 to 3.38) | 0.49 |
| Postpartum hemorrhage | 10 (2.0) | 17 (3.4) | −1.4 (−3.4 to 0.6) | 0.59 (0.27 to 1.27) | 0.17 |
| Neonatal complications | |||||
| Therapeutic abortion or fetal reduction due to fetal congenital anomalies during 12 to 28 weeks of gestationl | 6 (1.2) | 4 (0.8) | 0.4 (−0.8 to 1.6) | 1.49 (0.42 to 5.26) | 0.76 |
| Stillbirth | 8 (1.6) | 4 (0.8) | 0.8 (−0.6 to 2.2) | 1.99 (0.60 to 6.57) | 0.25 |
| Neonatal hospitalization > 3 days | 57 (11.5) | 31 (6.3) | 5.2 (1.7 to 8.7) | 1.83 (1.20 to 2.79) | 0.004 |
| Neonatal jaundice | 119 (23.9) | 101 (20.4) | 3.5 (−1.6 to 8.7) | 1.17 (0.93 to 1.48) | 0.18 |
| Neonatal infection | 24 (4.8) | 11 (2.2) | 2.6 (0.3 to 4.9) | 2.17 (1.08 to 4.39) | 0.03 |
| Neonatal death among live newborns | 1 (0.2) | 2 (0.4) | −0.2 (−0.9 to 0.5) | 0.50 (0.05 to 5.47) | 1.00 |
| Congenital anomalyl | 16 (3.2) | 10 (2.0) | 1.2 (−0.8 to 3.2) | 1.59 (0.73 to 3.48) | 0.24 |
| Participants with at least one of the maternal or neonatal complicationsm | 253 (50.9) | 217 (43.8) | 7.1 (0.9 to 13.3) | 1.16 (1.02 to 1.32) | 0.03 |
SD standard deviation. Two-sided P values. No adjustments were made for multiple comparisons. Two-sample t-test was used for continuous variable; Chi-square test or Fisher’s Exact Test was used for categorical data.
aAbsolute differences in percentages are indicated in percentage points, and absolute differences in other values are indicated in units of that value.
bLow birth weight was defined as a value of <2500 g.
cVery low birth weight was defined as a value of <1500 g.
dMacrosomia was defined as a value of >4000 g.
eBirthweight lower than the 10th percentile.
fBirthweight higher than the 90th percentile.
gPreterm premature rupture of membrane in the table refers to premature rupture of membrane before 37 weeks gestational age.
hPreterm birth was defined as delivery at less than 37 weeks gestational age.
iSpontaneous preterm birth was defined as preterm delivery due to spontaneous labor resulting from preterm premature rupture of membranes, cervical factors and other reasons.
jIatrogenic preterm birth was defined as a preterm birth resulting from a planned delivery due to maternal and/or fetal complications, including labor induction or cesarean section.
kVery preterm birth was defined as delivery at less than 32 weeks gestational age.
lDetails of congenital anomaly were listed in Supplementary Table 7.
mMaternal complications include gestational diabetes mellitus, preeclampsia or eclampsia, gestational hypertension, premature rupture of membrane, preterm birth, placenta previa, placental abruption, placental accreta, other placental abnormality, and postpartum hemorrhage. Neonatal complications include therapeutic abortion or fetal reduction due to fetal congenital anomalies during 12 to 28 weeks of gestation, stillbirth, neonatal hospitalization > 3 days, neonatal jaundice, neonatal infection, neonatal death among live newborns, congenital anomaly, low birth weight, macrosomia, small for gestational age, and large for gestational age.