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多囊卵巢综合征而非高雄激素血症对妊娠结局的影响:一项回顾性队列研究。

The effect of polycystic ovary syndrome without hyperandrogenism on pregnancy-related outcomes: a retrospective cohort study.

机构信息

Reproductive Medicine Centre, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China.

出版信息

BJOG. 2021 May;128(6):1003-1010. doi: 10.1111/1471-0528.16557. Epub 2021 Jan 6.

Abstract

OBJECTIVE

To evaluate the effect of polycystic ovary syndrome (PCOS) without hyperandrogenism on pregnancy-related outcomes.

DESIGN

A retrospective cohort study.

SETTING

Reproductive Medicine Centre of Tongji Hospital.

POPULATION

Women without hyperandrogenism undergoing their first single blastocyst transfers in frozen-thawed cycles were divided into a PCOS group and a non-PCOS group according to the Rotterdam criteria.

METHODS

The pregnancy-related outcomes of women with and without PCOS were compared. Propensity score matching and multiple logistic regression models were used to eliminate essential impacts on pregnancy-related outcomes.

MAIN OUTCOME MEASURES

Pregnancy-related outcomes included pregnancy loss and abnormal perinatal outcomes.

RESULTS

A total of 4083 women without hyperandrogenism met the study criteria, among whom 557 met the diagnostic criteria for PCOS. Women with PCOS had higher rates of clinical pregnancy (P = 0.035) and cumulative live births (P = 0.023). However, there were no significant differences in the rates of biochemical pregnancy, twins and pregnancy loss between the two groups. Among women with singleton pregnancies, the incidences of preterm birth, hypertensive disorders of pregnancy, gestational diabetes, placenta praevia, fetal malformation, macrosomia and low birthweight did not differ significantly between the two groups. The results remained unchanged even after adjustments were made for propensity score matching and multiple logistic regression analyses.

CONCLUSION

Women with PCOS without hyperandrogenism may achieve higher rates of clinical pregnancy and cumulative live birth than those without PCOS, without increases in their rates of biochemical pregnancy, pregnancy loss or other abnormal perinatal outcomes.

TWEETABLE ABSTRACT

PCOS without hyperandrogenism was not associated with abnormal pregnancy-related outcomes.

摘要

目的

评估不伴高雄激素血症的多囊卵巢综合征(PCOS)对妊娠相关结局的影响。

设计

回顾性队列研究。

地点

同济大学附属同济医院生殖医学中心。

人群

根据 Rotterdam 标准,将行首次冻融胚胎移植且不伴高雄激素血症的妇女分为 PCOS 组和非 PCOS 组。

方法

比较两组妇女的妊娠相关结局。采用倾向评分匹配和多因素逻辑回归模型消除对妊娠相关结局的重要影响。

主要观察指标

妊娠相关结局包括妊娠丢失和异常围生期结局。

结果

共有 4083 名不伴高雄激素血症的妇女符合研究标准,其中 557 名符合 PCOS 诊断标准。PCOS 组的临床妊娠率(P=0.035)和累积活产率(P=0.023)较高。但两组的生化妊娠率、双胞胎率和妊娠丢失率差异无统计学意义。在单胎妊娠妇女中,两组的早产、妊娠高血压疾病、妊娠期糖尿病、前置胎盘、胎儿畸形、巨大儿和低出生体重的发生率差异无统计学意义。即使在进行倾向评分匹配和多因素逻辑回归分析调整后,结果仍保持不变。

结论

不伴高雄激素血症的 PCOS 妇女可能比非 PCOS 妇女获得更高的临床妊娠率和累积活产率,而生化妊娠率、妊娠丢失率或其他异常围生期结局并无增加。

推文摘要

不伴高雄激素血症的 PCOS 与异常妊娠相关结局无关。

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