Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois.
Semin Reprod Med. 2023 Jul;41(3-04):80-86. doi: 10.1055/s-0043-1777759. Epub 2023 Dec 15.
Obesity affects nearly 40% of reproductive-aged women and has serious implications for women's overall and reproductive health. Women with an elevated body mass index (BMI) have higher rates of anovulation and irregular menses, lower success with fertility treatment, and significantly higher rates of pregnancy complications, such as hypertension/preeclampsia, gestational diabetes, and preterm delivery. Many studies have also shown an association between obesity and early pregnancy loss. However, the causal association between BMI and miscarriage has not been elucidated, likely due to the multifactorial effects that BMI may have on early pregnancy development. In addition, BMI as an isolated variable fails to capture other relevant confounding health risk factors, such as nutrition, physical activity, and insulin resistance. In this review, we will summarize the current literature demonstrating the association between BMI and miscarriage, highlight the research that attempts to explain the association, and finally provide data on therapeutic interventions to improve reproductive outcomes in women suffering from obesity and early pregnancy loss.
肥胖影响近 40%的育龄妇女，对妇女的整体和生殖健康有严重影响。体重指数（BMI）升高的女性排卵障碍和月经不规律的发生率更高，生育治疗的成功率更低，且妊娠并发症（如高血压/先兆子痫、妊娠期糖尿病和早产）的发生率显著更高。许多研究还表明肥胖与早期妊娠丢失之间存在关联。然而，BMI 与流产之间的因果关联尚未阐明，这可能是由于 BMI 对早期妊娠发育可能具有多种影响。此外，BMI 作为一个孤立的变量未能捕捉到其他相关的混杂健康风险因素，如营养、身体活动和胰岛素抵抗。在这篇综述中，我们将总结目前表明 BMI 与流产之间关联的文献，重点介绍试图解释这种关联的研究，并最终提供有关治疗干预措施的数据，以改善肥胖和早期妊娠丢失的女性的生殖结局。
