Fetal growth, fetal development, and placental features in women with polycystic ovary syndrome: analysis based on fetal and placental magnetic resonance imaging
Fetal growth, fetal development, and placental features in women with polycystic ovary syndrome: analysis based on fetal and placental magnetic resonance imaging
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多囊卵巢综合征女性的胎儿生长、胎儿发育和胎盘特征：基于胎儿和胎盘磁共振成像的分析
DOI：
10.1631/jzus.b2000350
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发表时间：
2020-12-01
影响因子：
5.1
通讯作者：
Qu, Fan
中科院分区：
文献类型：
--
作者：
Zhang, Qing;Bao, Zhong-kun;Qu, Fan
目的：多囊卵巢综合征（PCOS）是育龄妇女常见的内分泌代谢异常，可能与妊娠结局及子代结局有关。本研究旨在探讨母体多囊卵巢综合征是否影响胎儿生长、发育和胎盘特征。研究方法：本研究采用回顾性病例对照研究方法，选取60例PCOS孕妇（PCOS组）和120例健康非PCOS孕妇（对照组）。进行胎儿磁共振成像（MRI），然后进行超声检查和成像适应症，包括已知或疑似胎儿病理、既往妊娠或家族成员的胎儿异常史以及胎盘植入。分析胎儿MRI图像的头围（HC）、腹围（AC）、肺-肝信号强度比（LLSIR，胎儿肺成熟度的产前标志物）、胎儿肝脏和肾脏直径的长度、T2加权单次激发快速自旋回波（SSFSE）成像（rSISSFSE）上的胎盘相对信号强度和胎盘相对表观扩散系数值（rADC）。通过电话随访收集后代的身高和体重数据。结果如下：与对照组相比，PCOS组胎儿双顶径和股骨长度均小于对照组（P=0.026和P=0.005），（2）胎儿HC较小（32周后明显; P=0.044），（3）胎仔LLSIR较低，肝脏背腹侧长度较小（32周前明显;分别为P=0.005和P=0.019），和（4）胎盘厚度较小（32周前明显; P=0.017）。胎盘rSISSFSE和rADC在各组间差异无统计学意义（均P>0.05）。两组子代幼年期身高、体重差异均无统计学意义（均P>0.05）。结论：多囊卵巢综合征患者的胎儿生长、胎儿发育和胎盘特征存在改变。
Objective: Polycystic ovary syndrome (PCOS), a common endocrine-metabolic dysfunction in reproductiveaged women, may be involved in compromised pregnancy and offspring outcomes. This study aimed to investigate whether maternal PCOS affects fetal growth, fetal development, and placental features. Methods: This retrospective case-control study included 60 pregnant women with PCOS (PCOS group) and 120 healthy pregnant women without PCOS (control group). Fetal magnetic resonance imaging (MRI) was performed followed by an ultrasound examination and indications for imaging, including known or suspected fetal pathology, history of fetal abnormality in previous pregnancy or in a family member, and concern for placenta accreta. Fetal MRI images were analyzed for head circumference (HC), abdomen circumference (AC), lung-to-liver signal intensity ratio (LLSIR, a prenatal marker of fetal lung maturity), lengths of liver and kidney diameters in fetuses, and placental relative signal intensity on T2-weighted single-shot fast spin echo (SSFSE) imaging (rSISSFSE), and placental relative apparent diffusion coefficient value (rADC). Data on height and weight of offspring were collected through telephone follow-up. Results: Compared to the control group, the PCOS group showed the following characteristics: (1) smaller biparietal diameter and femur length in fetuses (P=0.026 and P=0.005, respectively), (2) smaller HC in fetuses (evident after 32 weeks; P=0.044), (3) lower LLSIR and smaller dorsoventral length of liver in fetuses (evident before 32 weeks; P=0.005 and P=0.019, respectively), and (4) smaller placental thickness (evident before 32 weeks; P=0.017). No significant differences in placental rSISSFSE or rADC were observed between the groups (all P>0.05). No significant differences in height and weight of offspring during childhood existed between the groups (all P>0.05). Conclusions: There exist alterations of fetal growth, fetal development, and placental features from women with PCOS.