Implications of Polycystic Ovary Syndrome for Pregnancy and for the Health of Offspring
Implications of Polycystic Ovary Syndrome for Pregnancy and for the Health of Offspring
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DOI：
10.1097/aog.0000000000000852
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发表时间：
2015-06-01
影响因子：
7.2
通讯作者：
Hart, Roger
中科院分区：
文献类型：
--
作者：
Doherty, Dorota A.;Newnham, John P.;Hart, Roger
目的：研究多囊卵巢综合征(PCOS)对产科、围产儿结局及子女的影响。方法：利用西澳大利亚州内的全州数据链接系统，对1997年至2011年间2566名确诊为PCOS且至少怀孕20周或以上的住院妇女与25660名年龄匹配的未住院的PCOS妇女的围产儿结局、先天异常和子女总体健康状况进行比较。住院情况按国际疾病分类进行分类，第10次修订的诊断按Kaplan-Meier估计的10年进行分类。在控制了母亲和围产期特征(包括母亲的糖尿病和肥胖)后，使用调整的优势比(OR)和风险比(HR)以95%的可信区间(CI)总结了多囊卵巢综合征的影响。结果：在患有多囊卵巢综合征的妇女(n=1,789)中，69.7%和62.9%(n=16,139)的多囊卵巢综合征妇女有一胎或多胎。对38361名子女进行了长达31年的住院检查。多囊卵巢综合征妇女的后代有更高的早产风险(15.5%比7.6%OR 1.74，95%可信区间1.53-1.98)，围产期死亡率(2.3%比0.7%，OR 1.49，95%CI 1.02-2.18)，更多的产后住院(14.1%比7.9%，OR 1.21，95%CI 1.05-1.40)，更多的先天异常(6.3%比4.9%，OR 1.20，心血管疾病(1.5%比1.0%，OR 1.37，95%CI 1.01~1.87)和泌尿生殖系统缺陷(2.0%比1.4%OR 1.36，95%CI 1.03-1.81)。母亲多囊卵巢综合征与子女住院率增加有关，包括代谢紊乱(7.9%比5.3%，HR 1.43，95%CI 1.26~1.65)、神经系统疾病(9.4%比6.9%，HR 1.17，95%CI 1.03~1.33)和哮喘(6.9%比4.9%，HR 1.32，95%CI 1.13~1.54)。
OBJECTIVE: To study the influence of polycystic ovary syndrome (PCOS) on obstetric and perinatal outcomes and on offspring in childhood.METHODS: Using statewide data linkage systems within Western Australia, 2,566 hospitalized women with a PCOS diagnosis and at least one pregnancy at 20 weeks of gestation or greater, between 1997 and 2011, were compared with 25,660 randomly selected age-matched women not hospitalized with a PCOS diagnosis with regard to perinatal outcomes, congenital anomalies, and general health of offspring. Hospitalizations were categorized by International Classification of Diseases, 10th Revision diagnoses and rates by 10 years by Kaplan-Meier estimates. Polycystic ovary syndrome effects were summarized using adjusted odds ratios (ORs) and hazard ratios (HRs) with 95% confidence intervals (CIs) after controlling for maternal and perinatal characteristics, including maternal diabetes and obesity.RESULTS: Of women with PCOS (n=1,789), 69.7% and 62.9% (n=16,139) of women without PCOS had one or more births. Hospitalizations up to 31 years were examined for 38,361 offspring. Offspring of women with PCOS were at higher risk of preterm birth (15.5% compared with 7.6% OR 1.74, 95% CI 1.53-1.98), perinatal mortality (2.3% compared with 0.7%, OR 1.49, 95% CI 1.02-2.18), more postnatal hospitalizations (14.1% compared with 7.9%, OR 1.21, 95% CI 1.05-1.40), more congenital anomalies (6.3% compared with 4.9%, OR 1.20, 95% CI 1.03-1.40), cardiovascular (1.5% compared with 1.0%, OR 1.37, 95% CI 1.01-1.87), and urogenital defects (2.0% compared with 1.4% OR 1.36, 95% CI 1.03-1.81). Maternal PCOS was associated with increased hospitalizations for their offspring, including metabolic disorder (7.9% compared with 5.3%, HR 1.43, 95% CI 1.26-1.65), disease of the nervous system (9.4% compared with 6.9%, HR 1.17, 95% CI 1.03-1.33), and asthma (6.9% compared with 4.9%, HR 1.32, 95% CI 1.13-1.54).CONCLUSION: Controlling for increased perinatal risk, maternal PCOS was associated with a predisposition to adverse health outcomes for their offspring.