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埃及妇女反复流产、多囊卵巢综合征病史和无上述两种情况的孕妇在妊娠三个阶段的睾酮、性激素结合球蛋白和脱氢表雄酮水平及宫颈长度。

Testosterone, sex hormone-binding globulin and dehydroepiandrosterone levels and cervical length of Egyptian women with a history of recurrent miscarriages, polycystic ovary syndrome and without the conditions at three stages of pregnancy.

机构信息

Barts Health NHS Trust and Queen Mary University, Newham University Hospital, London, UK.

Obstetrics and Gynaecology, Al Agouza Hospital, Agouza, Giza Governorate, Egypt.

出版信息

J Obstet Gynaecol. 2023 Dec;43(1):2163625. doi: 10.1080/01443615.2022.2163625.

Abstract

Total testosterone (TT), sex hormone-binding globulin (SHBG), dehydroepiandrosterone (DHEA) levels, and cervical length (CL) were investigated in pregnant Egyptian women with polycystic ovary syndrome (PCOS,  = 38), history of miscarriages (RM,  = 40) and without the conditions (HC,  = 40). At week 8, the RM had lower levels of TT ( 0.000) and free androgen index (FAI) ( = 0.000) and higher SHBG ( = 0.000) and DHEA ( < 0.05) than the PCOS. Compared with the HC, they had elevated SHBG ( < 0.05) and DHEA ( = 0.001) and reduced CL ( = 0.000). TT ( = 0.001) and FAI ( = 0.000) were higher and SHBG ( = 0.000) and CL ( = 0.001) lower in the PCOS than in the HC group. At week 16, TT ( = 0.000) and FAI ( = 0.000) were higher, and SHBG ( = 0.000) and CL ( < 0.05) lower in PCOS than in RM and HC. The PCOS had elevated FAI than the RM ( = 0.000) and HC ( = 0.001) at week 20. The DHEA, SHBG and CL abnormalities in PCOS and RM may compromise pregnancy outcomes.IMPACT STATEMENT Hyperandrogenaemia, low sex hormone-binding globulin (SHBG), shortened cervical length (CL) and polycystic ovary syndrome (PCOS) are the most cited risk factors for recurrent miscarriages (RM). However, the published data are inconsistent, perhaps because of the confounding effects of ethnicity and nutritional milieu. The study's findings comprising ethnically and socially homogenous women demonstrate that PCOS and RM are characterised by elevated dehydroepiandrosterone (DHEA) and shortened CL, and PCOS by reduced SHBG. These abnormalities would be expected to have an adverse impact on pregnancy outcomes. Twenty-weeks DHEA and CL values have the potential to predict outcome risk in women with a history of RM and PCOS. Further research on other population groups is required to validate the current study's findings.

摘要

总睾酮(TT)、性激素结合球蛋白(SHBG)、脱氢表雄酮(DHEA)水平和宫颈长度(CL)在患有多囊卵巢综合征(PCOS,=38)、有流产史(RM,=40)和无相关疾病的埃及孕妇(HC,=40)中进行了研究。在第 8 周时,RM 的 TT(=0.000)和游离雄激素指数(FAI)(=0.000)水平较低,SHBG(=0.000)和 DHEA(<0.05)水平较高,与 PCOS 相比。与 HC 相比,他们的 SHBG(<0.05)和 DHEA(=0.001)水平升高,CL(=0.000)降低。与 HC 组相比,PCOS 组的 TT(=0.001)和 FAI(=0.000)水平较高,SHBG(=0.000)和 CL(=0.001)水平较低。在第 16 周时,PCOS 组的 TT(=0.000)和 FAI(=0.000)水平较高,SHBG(=0.000)和 CL(<0.05)水平较低,高于 RM 和 HC。在第 20 周时,PCOS 组的 FAI 高于 RM(=0.000)和 HC(=0.001)。PCOS 和 RM 中的 DHEA、SHBG 和 CL 异常可能会影响妊娠结局。

研究结果表明,在同一种族和社会环境中,PCOS 和 RM 以 DHEA 升高和 CL 缩短为特征,而 PCOS 以 SHBG 降低为特征。这些异常预计会对妊娠结局产生不利影响。20 周的 DHEA 和 CL 值有可能预测有 RM 和 PCOS 病史的女性的结局风险。需要对其他人群进行进一步研究,以验证本研究的结果。

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