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多囊卵巢综合征非肥胖女性辅助生殖技术的不良妊娠结局:一项病例对照研究

Adverse pregnancy outcomes with assisted reproductive technology in non-obese women with polycystic ovary syndrome: a case-control study.

作者信息

Han Ae Ra, Kim Hye Ok, Cha Sun Wha, Park Chan Woo, Kim Jin Yeong, Yang Kwang Moon, Song In Ok, Koong Mi Kyoung, Kang Inn Soo

机构信息

Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital, Kwandong University College of Medicine, Seoul, Korea.

出版信息

Clin Exp Reprod Med. 2011 Jun;38(2):103-8. doi: 10.5653/cerm.2011.38.2.103. Epub 2011 Jun 30.

Abstract

OBJECTIVE

To investigate adverse pregnancy outcomes in non-obese women with polycystic ovary syndrome (PCOS) compared with obese-PCOS and control groups.

METHODS

Women with PCOS who underwent assisted reproductive technology (ART) from August, 2003 to December, 2007, were considered. A total of 336 women with PCOS were included in the study group and 1,003 infertile women who had tubal factor as an indication for ART were collected as controls. They were divided into four groups: a non-obese PCOS group, obese-PCOS group, non-obese tubal factor group, and obese tubal factor group, with obesity defined by a body mass index over 25 kg/m(2), and reviewed focusing on the basal characteristics, ART outcomes, and adverse pregnancy outcomes.

RESULTS

There was no difference among the groups' the clinical pregnancy rate or live birth rate. Regarding adverse pregnancy outcomes, the miscarriage rate, multiple pregnancy rate, and prevalence of preterm delivery and pregnancy induced hypertension were not different among the four groups. The incidence of small for gestational age infant was higher in the PCOS groups than the tubal factor groups (p<0.02). On the other hand, the morbidity of gestational diabetes mellitus (GDM) was not high in the non-obese PCOS group but was in the obese groups. And in the obese PCOS group, the newborns were heavier than in the other groups (p<0.02).

CONCLUSION

Non-obese PCOS presents many differences compared with obese PCOS, not only in the IVF-parameters but also in the morbidity of adverse pregnancy outcomes, especially in GDM and fetal macrosomia.

摘要

目的

研究非肥胖型多囊卵巢综合征(PCOS)女性与肥胖型PCOS女性及对照组相比的不良妊娠结局。

方法

纳入2003年8月至2007年12月接受辅助生殖技术(ART)的PCOS女性。研究组共纳入336例PCOS女性,收集1003例因输卵管因素行ART的不孕女性作为对照组。她们被分为四组:非肥胖型PCOS组、肥胖型PCOS组、非肥胖型输卵管因素组和肥胖型输卵管因素组,肥胖定义为体重指数超过25kg/m²,并重点回顾基础特征、ART结局和不良妊娠结局。

结果

各组的临床妊娠率或活产率无差异。关于不良妊娠结局,四组间的流产率、多胎妊娠率、早产和妊娠高血压的患病率无差异。PCOS组小于胎龄儿的发生率高于输卵管因素组(p<0.02)。另一方面,非肥胖型PCOS组妊娠期糖尿病(GDM)的发病率不高,但肥胖组较高。并且在肥胖型PCOS组中,新生儿比其他组更重(p<0.02)。

结论

非肥胖型PCOS与肥胖型PCOS相比存在许多差异,不仅在体外受精参数方面,而且在不良妊娠结局的发病率方面,尤其是在GDM和巨大儿方面。

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