Does the presence of polycystic ovary syndrome increase the risk of obstetrical complications in women with gestational diabetes?
Does the presence of polycystic ovary syndrome increase the risk of obstetrical complications in women with gestational diabetes?
复制标题
DOI：
10.3109/14767050903214566
复制
发表时间：
2010-06-01
影响因子：
1.8
通讯作者：
Feig, Denice S.
中科院分区：
文献类型：
--
作者：
Alshammari, Abdulmuhsen;Hanley, Anthony;Feig, Denice S.
Objective.确定与单纯妊娠期糖尿病（GDM）患者相比，多囊卵巢综合征（PCOS）合并GDM患者发生产科并发症的风险是否增加。一项回顾性队列研究比较了GDM合并PCOS妇女与单纯GDM妇女的母亲/胎儿结局。分类变量采用Fisher精确检验，连续变量采用t检验。Logistic回归模型允许计算每种结局的比值比和95%置信区间（CI），并对混杂因素进行调整。171名妇女被纳入这项研究。GDM和PCOS合并妊娠高血压/先兆子痫的妇女明显更多（15.9% vs. 3.9%，p = 0.019，OR = 4.62，95%CI = 1.38-15.41）。多元逻辑回归显示，在控制体重指数（p = 0.028，OR = 4.43，95%CI = 1.17-16.72）和产次（p = 0.050，OR = 3.45，95%CI = 1.00-11.92）后，这种增加持续存在。患有GDM和PCOS的女性往往有更多的早产（25.0% vs. 11.8%，p = 0.063）。更多GDM和PCOS女性的婴儿需要光疗治疗高胆红素血症（25.0% vs. 7.9%，p = 0.0066，OR = 3.90，95% CI = 1.52-9.98）。Logistic回归分析显示，在控制了早产因素后，这种关联仍然存在（OR = 3.18，95%CI = 1.14-8.82，p = 0.026）。患有这两种疾病的母亲应该更仔细地监测，并就其增加的母亲和胎儿并发症的风险提供咨询。
Objective. To determine whether women with both polycystic ovary syndrome (PCOS) and gestational diabetes mellitus (GDM) have an increased risk of obstetric complications compared with women with GDM alone.Methods. A retrospective cohort study of maternal/fetal outcomes in women with GDM and PCOS was compared with women with GDM alone. Outcomes were compared using Fisher's exact test for categorical variables and t-test for continuous variables. Logistic regression models allowed for the calculation of odds ratios and 95% confidence intervals (CIs) for each outcome, adjusted for confounding.Results. One hundred seventy one women were included in the study. Significantly more women with both GDM and PCOS had pregnancy-induced hypertension/preeclampsia (15.9% vs. 3.9%, p = 0.019, OR = 4.62, 95% CI = 1.38-15.41). Multiple logistic regression revealed that this increase persisted after controlling for body mass index (p = 0.028, OR = 4.43, 95% CI = 1.17-16.72) and parity (p = 0.050, OR = 3.45, 95% CI = 1.00-11.92). Women with GDM and PCOS tended to have more preterm deliveries (25.0% vs. 11.8%, p = 0.063). More infants of women with GDM and PCOS required phototherapy treatment for hyperbilirubinemia (25.0% vs. 7.9%, p = 0.0066, OR = 3.90, 95% CI = 1.52-9.98). Logistic regression revealed that this association persisted after controlling for preterm delivery (OR = 3.18, 95% CI = 1.14-8.82, p = 0.026).Conclusions. Mothers with both disorders should be monitored more carefully and counseled regarding their increased risk of both maternal and fetal complications.