Department of Traditional Chinese Medicine Gynecology, Changhai Hospital, Shanghai, China.
Department of Traditional Chinese Medicine Gynecology, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Front Endocrinol (Lausanne). 2022 Jun 6;13:878853. doi: 10.3389/fendo.2022.878853. eCollection 2022.
This work aimed to evaluate the adverse effect of polycystic ovary syndrome (PCOS) on pregnancy outcomes of singletons after vitrification in women with frozen-thawed embryo transfer (FET).
Patients with/without PCOS who underwent FET from January 2013 and December 2018 were included. Propensity score matching (PSM) was used to reduce the influence of bias. Logistic regression was applied to identify the risk factors of adverse pregnancy outcomes of singletons in women with PCOS.
After PSM, the PCOS group had shorter gestational age (P<0.001) and lower newborn birth weight than the non-PCOS group (P=0.045). Compared with the non-PCOS group, the PCOS group had an increased risk of gestational diabetes mellitus (GDM) and pregnancy-induced hypertension (PIH) (P<0.001), placenta and membrane abnormality (P<0.001), stillbirth (P<0.001), neonatal complication (P=0.014), and miscarriage rate (P<0.001). Neonatal complication was associated with parity (adjusted OR=1.202, 95% CI=1.002-1.443, P=0.048) and basal P level (adjusted OR=1.211, 95% CI=1.021-1.436, P=0.028). According to multivariable logistic regression analysis, the miscarriage rate was related to parity (adjusted OR=1.201, 95% CI=1.057-1.166, P=0.005) and basal E2 (adjusted OR=1.002, 95% CI=1.000-1.004, P=0.019) and P levels on the day of embryo transfer (adjusted OR=0.971, 95% CI=0.957-0.985, P<0.001).
Compared with non-PCOS women, women with PCOS have a higher risk of GDM and PIH, and neonatal complications and therefore require additional care during pregnancy and parturition.
本研究旨在评估多囊卵巢综合征（PCOS）对冻融胚胎移植（FET）后行玻璃化冻存单胎妊娠结局的影响。
纳入 2013 年 1 月至 2018 年 12 月行 FET 的 PCOS 组和非 PCOS 组患者。采用倾向性评分匹配（PSM）减少偏倚影响。采用 logistic 回归分析识别 PCOS 患者单胎妊娠不良结局的危险因素。
PSM 后，PCOS 组较非 PCOS 组的孕龄更短（P<0.001），新生儿出生体重更低（P=0.045）。与非 PCOS 组相比，PCOS 组发生妊娠期糖尿病（GDM）和妊娠高血压（PIH）（P<0.001）、胎盘和胎膜异常（P<0.001）、死胎（P<0.001）、新生儿并发症（P=0.014）和流产率（P<0.001）的风险增加。新生儿并发症与产次（调整后的 OR=1.202，95%CI=1.002-1.443，P=0.048）和基础 P 水平（调整后的 OR=1.211，95%CI=1.021-1.436，P=0.028）有关。多变量 logistic 回归分析显示，流产率与产次（调整后的 OR=1.201，95%CI=1.057-1.166，P=0.005）和基础 E2（调整后的 OR=1.002，95%CI=1.000-1.004，P=0.019）及胚胎移植日 P 水平（调整后的 OR=0.971，95%CI=0.957-0.985，P<0.001）有关。
与非 PCOS 女性相比，PCOS 女性发生 GDM 和 PIH、新生儿并发症的风险更高，因此需要在妊娠和分娩期间给予额外的关注。
