Obstetric outcome in women with polycystic ovarian syndrome
Obstetric outcome in women with polycystic ovarian syndrome
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DOI：
10.1093/humrep/16.2.226
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发表时间：
2001-02-01
影响因子：
6.1
通讯作者：
Tiitinen, A
中科院分区：
文献类型：
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作者：
Mikola, M;Hiilesmaa, V;Tiitinen, A
患有多囊卵巢综合征(PCOS)的女性通常有胰岛素抵抗和高胰岛素血症，因此患妊娠期糖尿病(GDM)的风险可能会增加。高胰岛素血症也可能与先兆子痫有关，关于多囊卵巢综合征妇女妊娠结局的信息很少，也有一定的争议。因此，对患有多囊卵巢综合征的女性的99例妊娠进行了回顾性评估，并将结果与未选定的对照人群进行了比较。多囊卵巢综合征患者的平均体重指数高于对照组(25.6vs23.0)(P<；0.0001)，且多囊卵巢综合征患者的自然流产发生率(76%vs42%)高于对照组(P<；0.001)。PCOS组多胎妊娠率为9.1%，对照组为1.1%[优势比(OR)9.0；95%可信区间(CI)3.5~23.3]。20%的多囊卵巢综合征患者和8.9%的对照组发生妊娠期糖尿病(P<；0.001)。经Logistic回归分析，BMI和GT；25似乎是GDM的最大预测因素(调整后的OR为5.1；CI为3.2~8.3)，而PCOS仍是另一个独立预测因素(调整后的OR为1.9；CI为1.0~3.5)。相比之下，多囊卵巢综合征并不是先兆子痫的重要预测因子，而先兆子痫只是与无胎相关。早产(多囊卵巢综合征组为16.1%，对照组为6.5%)在很大程度上是由多胎妊娠引起的，其次是流产和多囊卵巢综合征。在单胎妊娠中，出生体重、阿普加评分或婴儿围产期发病率没有差异。总而言之，PCOS略微增加了GDM的风险，但对早产和先兆子痫的发生率没有重要影响。
Women with polycystic ovarian syndrome (PCOS) often have insulin resistance and hyperinsulinaemia and may therefore be at an increased risk for gestational diabetes mellitus (GDM). Hyperinsulinaemia may also be associated with pre-eclampsia, Information concerning outcome of pregnancies in PCOS women is scanty and somewhat controversial. Therefore, 99 pregnancies were retrospectively evaluated in women with PCOS and the findings were compared with an unselected control population. The average body mass index (BMI) in PCOS patients was greater than that in controls (25.6 versus 23.0) (P < 0.0001), and PCOS patients were more often nulliparous than controls (76 versus 42%) (P < 0.001). The multiple pregnancy rate was 9.1% in PCOS patients and 1.1% in controls [odds ratio (OR) 9.0; 95% confidence interval (CI) 3.5-23.3]. GDM developed in 20% of the PCOS patients and in 8.9% of the controls (P < 0.001). After logistic regression analysis, BMI >25 seemed to be the greatest predictor for GDM (adjusted OR 5.1; CI 3.2-8.3), while PCOS remained as another independent predictor (adjusted OR 1.9; CI 1.0-3.5). In contrast, PCOS was not a significant predictor for pre-eclampsia, which was merely associated with nulliparity. Premature delivery (16.1% in PCOS and 6.5% in controls) was explained to a large extent by multiple pregnancies and marginally by nulliparity and PCOS. In singleton pregnancies, there was no difference in birth weights, Apgar scores or perinatal morbidity of infants. In conclusion, PCOS slightly increases the risk for GDM, but does not have an important effect on the rate of premature delivery and pre-eclampsia.