Department of Obstetrics and Gynecology (T.S.L., S.S., E.V.) and Department of Endocrinology (S.M.C.), St. Olav's Hospital, Trondheim University Hospital, 7006 Trondheim, Norway; Department of Laboratory Medicine, Children's and Women's Health (T.S.L., S.S., E.V.) and Department of Cancer Research and Molecular Medicine (S.M.D.), Norwegian University of Science and Technology, 7491 Trondheim, Norway; and Department of Public Health and General Practice (Ø.S.), 7491 Trondheim, Norway.
J Clin Endocrinol Metab. 2016 Jun;101(6):2325-31. doi: 10.1210/jc.2015-3498. Epub 2016 Feb 2.
Women with polycystic ovary syndrome (PCOS) have increased risk of preterm delivery. Shortening of the cervix is a sign of preterm delivery.
This study aimed to investigate potential effect of metformin on cervical length and whether androgen levels correlate with cervical length in PCOS pregnancies.
This was a sub-study of a randomized, placebo-controlled, multicenter study (The PregMet study) performed at 11 secondary or tertiary centers from 2005 to 2009.
Two-hundred sixty-one pregnancies of 245 women with PCOS, age 18-42 years participated.
Participants were randomly assigned to metformin or placebo from first trimester to delivery.
We compared cervical length and androgen levels in metformin and placebo groups at gestational weeks 19 and 32. We also explored whether cervical length correlated with androgen levels.
We found no difference in cervical length between the metformin and the placebo groups at gestational week 19 and 32. Dehydroepiandrosterone (DHEAS) tended to be higher in the metformin group. There were no correlations between androgens and cervical length at week 19. At gestational week 32, androstenedione (P = .02) and DHEAS (P = .03) showed a trend toward negative correlation to cervical length. High androstenedione level correlated with shortening of cervical length from week 19 to 32 when adjusted for confounders (P = .003). T (P = .03), DHEAS (P = .02), and free testosterone index (P = .03) showed a similar trend.
Metformin in pregnancy did not affect cervical length in women with PCOS. High maternal androgen levels correlated with cervical shortening from the second to the third trimester of pregnancy, as a sign of cervical ripening.
多囊卵巢综合征（PCOS）患者早产风险增加。宫颈缩短是早产的一个迹象。
本研究旨在探讨二甲双胍对宫颈长度的潜在影响，以及雄激素水平是否与 PCOS 妊娠的宫颈长度相关。
这是一项 2005 年至 2009 年在 11 个二级或三级中心进行的随机、安慰剂对照、多中心研究（PregMet 研究）的子研究。
245 名 PCOS 患者的 261 例妊娠，年龄 18-42 岁。
参与者从孕早期到分娩时被随机分配到二甲双胍或安慰剂组。
我们比较了 19 周和 32 周时二甲双胍组和安慰剂组的宫颈长度和雄激素水平。我们还探讨了宫颈长度与雄激素水平之间是否存在相关性。
我们发现 19 周和 32 周时二甲双胍组和安慰剂组的宫颈长度无差异。二甲双胍组脱氢表雄酮（DHEAS）水平偏高。19 周时，雄激素与宫颈长度之间无相关性。32 周时，雄烯二酮（P =.02）和 DHEAS（P =.03）与宫颈长度呈负相关趋势。在校正混杂因素后，高雄烯二酮水平与 19 周至 32 周宫颈长度缩短相关（P =.003）。T（P =.03）、DHEAS（P =.02）和游离睾酮指数（P =.03）也有类似的趋势。
孕期使用二甲双胍并未影响 PCOS 患者的宫颈长度。高母体内分泌雄激素水平与妊娠中晚期宫颈缩短相关，提示宫颈成熟。
