Division of Obstetrics and Gynecology, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy -
Division of Obstetrics and Gynecology, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy.
Minerva Obstet Gynecol. 2022 Feb;74(1):45-59. doi: 10.23736/S2724-606X.21.04758-4. Epub 2021 Apr 20.
Polycystic ovarian syndrome (PCOS) is the most common endocrinological disease of reproductive-aged women, with an estimated incidence ranging from 5% to 15%. The clinical manifestations of PCOS are heterogeneous and vary according to the age of the patient. Insulin resistance (IR), hyperandrogenism, and obesity are widely assumed to play a pivotal role in the pathophysiological mechanism of PCOS. As previously stated by many conducted meta-analyses, PCOS can cause a rising risk of pregnancy complications, including maternal, fetal, and neonatal complications. Pregnancy-induced hypertension (PIH), preeclampsia (PE), gestational diabetes mellitus (GDM), spontaneous preterm birth (PTB), and an increased necessity for a cesarean section (CS) are the most documented maternal implications. Regarding fetal outcomes, PCOS has also been correlated with elevated neonatal morbidity, prematurity, fetal growth restriction (FGR), birth weight variations (large for gestational age [LGA] and small for gestational age [SGA]), and transfer to the Neonatal Intensive Care Unit (NICU). Owing to the variability of the studies performed, the association of PCOS with an elevated risk of adverse pregnancy outcomes is still controversial. This variability is found in the diagnosis and clinical presentations of PCOS, and can be influenced by prepregnancy circumstances and therapies as well as particular population and environmental features. The Amsterdam Consensus Guidelines confirm that obesity and IR can worsen maternal and fetal complications; thus, a closer follow-up should be offered to PCOS women during pregnancy.
多囊卵巢综合征（PCOS）是生殖期妇女最常见的内分泌疾病，估计发病率在 5%至 15%之间。PCOS 的临床表现具有异质性，且因患者年龄而异。胰岛素抵抗（IR）、高雄激素血症和肥胖症被广泛认为在 PCOS 的病理生理机制中起关键作用。正如许多已进行的荟萃分析所指出的，PCOS 会增加妊娠并发症的风险，包括母婴和新生儿并发症。妊娠高血压（PIH）、子痫前期（PE）、妊娠期糖尿病（GDM）、自发性早产（PTB）和剖宫产（CS）的必要性增加是最常见的母婴并发症。关于胎儿结局，PCOS 也与新生儿发病率增加、早产、胎儿生长受限（FGR）、出生体重变化（大于胎龄 [LGA] 和小于胎龄 [SGA]）以及转入新生儿重症监护病房（NICU）有关。由于所进行的研究存在变异性，因此 PCOS 与不良妊娠结局风险增加之间的关联仍存在争议。这种变异性存在于 PCOS 的诊断和临床表现中，并可能受到孕前情况和治疗以及特定人群和环境特征的影响。阿姆斯特丹共识指南证实肥胖症和 IR 会加重母婴并发症；因此，应该在怀孕期间为 PCOS 妇女提供更密切的随访。
