Homburg Roy
Reproductive Medicine Division, VU University Medical Centre, P.O. Box 7057, 1007MB Amsterdam, The Netherlands.
Best Pract Res Clin Endocrinol Metab. 2006 Jun;20(2):281-92. doi: 10.1016/j.beem.2006.03.009.
Complications of pregnancy associated with maternal PCOS include increased prevalence of early pregnancy loss (EPL), gestational diabetes (GDM), pregnancy-induced hypertensive disorders (PET/PIH), and the birth of small-for-gestational-age (SGA) babies. Increased risk of EPL has been attributed to obesity, hyperinsulinaemia, elevated luteinizing hormone concentrations, and endometrial dysfunction. Avoiding obesity before pregnancy and treatment with metformin are therapeutic options, also for the increased prevalence of GDM. Administration of metformin throughout pregnancy is a contentious issue. Screening pregnant women with PCOS for GDM and PET/PIH-especially if they are obese-is recommended, although data for a firm association between PCOS and PET/PIH is weak. Impaired insulin-mediated growth and fetal programming are possible explanations for a higher prevalence of SGA infants in mothers with PCOS. Only prospective studies employing a large cohort of women with well-defined PCOS compared with a control group matched for BMI and parity can solve the remaining questions.
与母亲多囊卵巢综合征（PCOS）相关的妊娠并发症包括早期妊娠丢失（EPL）、妊娠期糖尿病（GDM）、妊娠高血压疾病（PET/PIH）以及小于胎龄儿（SGA）出生的发生率增加。EPL风险增加归因于肥胖、高胰岛素血症、黄体生成素浓度升高和子宫内膜功能障碍。孕前避免肥胖以及使用二甲双胍治疗也是应对GDM发生率增加的治疗选择。整个孕期使用二甲双胍是一个有争议的问题。建议对患有PCOS的孕妇进行GDM和PET/PIH筛查，尤其是如果她们肥胖，尽管PCOS与PET/PIH之间确切关联的数据很薄弱。胰岛素介导的生长受损和胎儿编程可能是PCOS母亲中SGA婴儿患病率较高的原因。只有采用大量明确诊断为PCOS的女性队列并与匹配BMI和产次的对照组进行比较的前瞻性研究才能解决其余问题。
