Foroozanfard Fatemeh, Asemi Zatollah, Bazarganipour Fatemeh, Taghavi Seyed Abdolvahab, Allan Helen, Aramesh Shahintaj
Gametogenesis Research Center, Kashan University of Medical Sciences, Kashan, Iran.
Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran.
Gynecol Endocrinol. 2020 Jan;36(1):61-65. doi: 10.1080/09513590.2019.1631278. Epub 2019 Jul 2.
The aim of this study was to compare pregnancy, childbirth, and neonatal outcomes in women with different phenotypes of polycystic ovary syndrome (PCOS) with healthy women. A prospective cohort study from the beginning to the end of pregnancy for 41 pregnant women with PCOS (case) and 49 healthy pregnant women (control) was completed. Based on the presence or absence of menstrual dysfunction (M), hyperandrogenism (HA), and polycystic ovaries (PCO) on ultrasound, the PCOS (case) group were divided into three phenotypes (HA + PCO ( = 22), M + PCO ( = 9), HA + M+PCO ( = 10). Pre-eclampsia, gestational diabetes, and lower birth weight among newborns were significantly higher in the PCOS case group compared to the control group especially in the phenotype HA + M+PCO ( < .05). High BMI ( = 2.40; =.03) was the strongest predictor of pre-eclampsia in patients with PCOS. High androgen levels (free androgen index) ( = 13.71, 3.02; < .05), was the strongest predictor of developing diabetes during pregnancy and reduced birth weight baby, respectively.These results suggest that PCOS, particularly in phenotype HA + M+PCO ( < .05), is a risk factor for adverse pregnancy and neonatal outcomes including gestational diabetes, pre-eclampsia, and reduced weight babies.
本研究的目的是比较不同表型多囊卵巢综合征(PCOS)女性与健康女性的妊娠、分娩及新生儿结局。对41例患有PCOS的孕妇(病例组)和49例健康孕妇(对照组)进行了从妊娠开始至结束的前瞻性队列研究。根据超声检查有无月经功能障碍(M)、高雄激素血症(HA)和多囊卵巢(PCO),将PCOS病例组分为三种表型(HA+PCO(=22)、M+PCO(=9)、HA+M+PCO(=10))。与对照组相比,PCOS病例组中先兆子痫、妊娠期糖尿病和新生儿低出生体重的发生率显著更高,尤其是在HA+M+PCO表型中(P<0.05)。高BMI(β=2.40,P=0.03)是PCOS患者先兆子痫的最强预测因素。高雄激素水平(游离雄激素指数)(β=13.71,P=3.02;P<0.05)分别是妊娠期患糖尿病和出生体重降低婴儿的最强预测因素。这些结果表明,PCOS,尤其是HA+M+PCO表型(P<0.05),是包括妊娠期糖尿病、先兆子痫和低体重儿在内的不良妊娠和新生儿结局的危险因素。