Department of Obstetrics and Gynecology, Stanford Hospital and Clinics, Stanford, CA, USA.
Hum Reprod. 2010 May;25(5):1123-6. doi: 10.1093/humrep/deq025. Epub 2010 Feb 26.
Obesity has been identified as a risk factor for spontaneous miscarriage although the mechanism is unclear. The purpose of this study is to better understand the effect of obesity on early pregnancy success by examining the cytogenetic results of miscarriages in women with normal and elevated body mass index (BMI).
We conducted a retrospective case-control study in an academic infertility practice. Medical records of women ages <40 years with first trimester missed abortion (n = 204), who underwent dilatation and curettage between 1999 and 2008, were reviewed for demographics, BMI, diagnosis of polycystic ovary syndrome (PCOS) and karyotype analysis. chi(2) and Student's t-test analysis were used for statistical analysis, with P < 0.05 considered significant.
A total of 204 miscarriages were included, from women with a mean age of 34.5 years. The overall rate of aneuploidy was 59%. Women with BMI > or = 25 kg/m(2) had a significant increase in euploid miscarriages compared with women with lower BMI (P = 0.04), despite a similar mean age (34.4 years for both).
We found a significant increase in normal embryonic karyotypes in the miscarriages of overweight and obese women (BMI > or = 25). These results suggest that the excess risk of miscarriages in the overweight and obese population is independent of embryonic aneuploidy. Further studies are needed to assess the impact of lifestyle modification, insulin resistance and PCOS on pregnancy outcomes in the overweight and obese population.
肥胖已被确定为自然流产的一个危险因素，尽管其机制尚不清楚。本研究的目的是通过检查正常和升高的体重指数（BMI）女性流产的细胞遗传学结果，更好地了解肥胖对早期妊娠成功的影响。
我们在一个学术性不孕不育诊所进行了回顾性病例对照研究。对 1999 年至 2008 年间因早期妊娠流产（n = 204）而行扩张刮宫术的年龄<40 岁女性的病历进行回顾性分析，评估其人口统计学特征、BMI、多囊卵巢综合征（PCOS）诊断和核型分析。采用卡方检验和学生 t 检验进行统计学分析，P < 0.05 为差异有统计学意义。
共纳入 204 例流产病例，患者平均年龄为 34.5 岁。非整倍体率为 59%。与 BMI 较低的女性相比，BMI ≥ 25 kg/m2 的女性具有更高的整倍体流产率（P = 0.04），尽管平均年龄相似（两者均为 34.4 岁）。
我们发现超重和肥胖女性（BMI ≥ 25）流产中正常胚胎染色体核型显著增加。这些结果表明，超重和肥胖人群流产风险增加与胚胎非整倍体无关。需要进一步研究来评估生活方式改变、胰岛素抵抗和 PCOS 对超重和肥胖人群妊娠结局的影响。
