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多囊卵巢综合征女性的妊娠和新生儿并发症与妊娠中期抗苗勒管激素水平的关系。

Pregnancy and neonatal complications in women with polycystic ovary syndrome in relation to second-trimester anti-Müllerian hormone levels.

机构信息

Department of Women's and Children's Health, Uppsala University Uppsala, Sweden.

Department of Women's and Children's Health, Uppsala University Uppsala, Sweden; Centre for Clinical Research Sörmland, Uppsala University Eskilstuna, Sweden.

出版信息

Reprod Biomed Online. 2019 Jul;39(1):141-148. doi: 10.1016/j.rbmo.2019.02.004. Epub 2019 Feb 27.

Abstract

RESEARCH QUESTION

An association has been found between high anti-Müllerian hormone (AMH) levels during pregnancy and the development of polycystic ovary syndrome (PCOS)-like phenotypic traits in mouse offspring. The aim of this study was to determine whether AMH levels are associated with maternal testosterone levels, and whether high AMH concentration influences the risk of developing PCOS-related adverse pregnancy outcomes.

DESIGN

Maternal serum AMH, testosterone and sex hormone binding globulin levels were measured in blood samples taken in early second-trimester pregnancies from women with PCOS (n = 159) and healthy controls matched for body mass index (n = 320). Possible associations with preeclampsia, gestational hypertension, gestational diabetes, preterm birth and birthweight was explored by logistic and linear regression models.

RESULTS

Women with PCOS had higher AMH, higher total testosterone levels and higher free androgen index than controls (P < 0.001 for all three parameters). Among women with PCOS, high testosterone levels (B = 2.7; β = 0.26; P = 0.001) and low first trimester body mass index (B = -0.5; β = -0.17; P = 0.043) remained independently associated with AMH. High AMH levels were associated with decreased risk of gestational hypertension (adjusted OR 0.55; 95% CI 0.34 to 0.87), but no association was found with other adverse pregnancy outcomes or birthweight.

CONCLUSIONS

Women with PCOS had higher AMH levels during pregnancy compared with controls, but high AMH was not associated with increased risk of adverse pregnancy outcomes or birthweight.

摘要

研究问题

在怀孕过程中,高抗苗勒氏管激素(AMH)水平与多囊卵巢综合征(PCOS)样表型特征在小鼠后代中的发展之间存在关联。本研究旨在确定 AMH 水平是否与母体睾酮水平相关,以及高 AMH 浓度是否会影响发生与 PCOS 相关的不良妊娠结局的风险。

设计

从患有 PCOS(n=159)和健康对照组(n=320)的女性的早期妊娠中期血液样本中测量了母体血清 AMH、睾酮和性激素结合球蛋白水平。通过逻辑回归和线性回归模型探讨了与子痫前期、妊娠高血压、妊娠糖尿病、早产和出生体重的可能关联。

结果

患有 PCOS 的女性的 AMH、总睾酮水平和游离雄激素指数均高于对照组(所有三个参数的 P<0.001)。在患有 PCOS 的女性中,高睾酮水平(B=2.7;β=0.26;P=0.001)和低孕早期 BMI(B=-0.5;β=-0.17;P=0.043)与 AMH 独立相关。高 AMH 水平与妊娠高血压的风险降低相关(调整后的 OR 0.55;95% CI 0.34 至 0.87),但与其他不良妊娠结局或出生体重无关。

结论

与对照组相比,患有 PCOS 的女性在怀孕期间的 AMH 水平更高,但高 AMH 与不良妊娠结局或出生体重增加无关。

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