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多囊卵巢综合征妇女妊娠糖尿病的代谢参数和围产结局。

Metabolic parameters and perinatal outcomes of gestational diabetes mellitus in women with polycystic ovary syndrome.

机构信息

Beijing Obstetrics and Gynecology Hospital, Capital Medical [corrected] University, Beijing, PR China.

出版信息

J Perinat Med. 2010 Mar;38(2):141-6. doi: 10.1515/jpm.2010.034.

Abstract

AIMS

To investigate metabolic characteristics and perinatal outcomes of gestational diabetes mellitus (GDM) in women with polycystic ovary syndrome (PCOS).

METHODS

We evaluated 34 GDM in women with PCOS and 70 GDM in women without PCOS in this prospective study. All GDM women were treated with medical nutrition therapy (MNT). Pre-pregnancy clinical data, fasting glucose, fasting insulin (FINS), blood lipid, homeostasis model assessment index of insulin resistance (HOMA-IR) and perinatal outcomes were investigated.

RESULTS

GDM in women with PCOS had higher pre-pregnancy body mass index (BMI), higher incidence of overweight than in the non-PCOS group (each P<0.001). Incidence of history of infertility was also significantly higher in the PCOS group than in the non-PCOS group (20.6% vs. 2.9%, P<0.01). A higher incidence of early pregnancy loss (EPL) was found in the PCOS group than in the non-PCOS group (20.6% vs. 7.1%, P<0.05). Significantly higher in vitro fertilization and embryo transfer (IVF-ET) rate and insulin administration was also observed in the PCOS group than in the controls. No significant difference was found in the prevalence of preeclampsia, premature delivery, macrosomia, fetal death and neonatal congenital anomaly between GDM in women with and without PCOS (all P>0.05). [corrected]

CONCLUSIONS

Compared with the controls, no significant increase in the incidence of adverse perinatal outcomes was detected in GDM in women with PCOS by appropriate management.

摘要

目的

研究多囊卵巢综合征(PCOS)妇女妊娠糖尿病(GDM)的代谢特征和围产结局。

方法

本前瞻性研究纳入 34 例 PCOS 合并 GDM 妇女和 70 例非 PCOS 合并 GDM 妇女。所有 GDM 妇女均采用医学营养治疗(MNT)。研究分析了这些 GDM 妇女的孕前临床数据、空腹血糖、空腹胰岛素(FINS)、血脂、胰岛素抵抗稳态模型评估指数(HOMA-IR)以及围产结局。

结果

与非 PCOS 组相比,PCOS 合并 GDM 妇女孕前体质量指数(BMI)更高(P<0.001),超重发生率更高(P<0.001)。PCOS 组不孕史发生率也明显高于非 PCOS 组(20.6% vs. 2.9%,P<0.01)。PCOS 组早期妊娠丢失(EPL)发生率高于非 PCOS 组(20.6% vs. 7.1%,P<0.05)。PCOS 组体外受精-胚胎移植(IVF-ET)率和胰岛素使用率也明显高于对照组。两组 GDM 妇女的子痫前期、早产、巨大儿、胎儿死亡和新生儿先天畸形发生率差异均无统计学意义(均 P>0.05)。

结论

经适当管理,PCOS 合并 GDM 妇女的围产不良结局发生率与对照组相比无显著增加。

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