Aihaiti Reweiguli, Shen Ziyun, Wu Xian, Niu Zhihong
Department of Obstetrics and Gynecology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
Fertil Steril. 2024 Dec;122(6):1055-1062. doi: 10.1016/j.fertnstert.2024.07.017. Epub 2024 Jul 21.
To determine whether polycystic ovary syndrome (PCOS) increases adverse pregnancy and birth outcomes in women undergoing frozen embryo transfer (FET).
Retrospective cohort study. The PCOS group was matched 1:2 with the control group population using propensity score matching.
Not applicable.
PATIENT(S): During an 8-year period, 2,955 patients aged 20-40 years who underwent FET and delivered between January 2015 and December 2022 at the Reproductive Medical Center of Ruijin Hospital were evaluated for adverse pregnancy outcomes.
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): All patients were assessed for specific pregnancy complications and birth outcomes, with a sub-group analysis conducted to compare patients with PCOS with and without hyperandrogenism.
Women with PCOS demonstrated higher rates of gestational diabetes mellitus (24.9% vs. 16.4%; relative risk [RR], 1.51; 95% confidence interval [CI], 1.26-1.82; P<.001), gestational hypertension (12.2% vs. 8.9%; RR, 1.37; 95% CI, 1.05-1.80; P=.022), preterm prelabor rupture of membranes (7.0% vs. 3.6%; RR, 1.92; 95% CI, 1.29-2.86; P=.001), cervical length shortening (1.8% vs. 0.4%; RR, 8.39; 95% CI, 1.56-12.49; P=.002), large-for-gestational age (17.4% vs. 13.7%; RR, 1.27; 95% CI, 1.02-1.57; P=.032), and low birth weight (19.9% vs. 16.0%; RR, 1.25; 95% CI, 1.02-1.52; P=.030) in overall propensity score matching analysis. Newborns of patients with PCOS had a higher risk of preterm birth <37 weeks (10.5% vs. 6.6%; RR, 1.59; 95% CI, 1.12-2.26; P=.009) in singleton pregnancies. Patients with PCOS with hyperandrogenism showed a higher incidence of cervical length shortening (5.5% vs. 0.5%; adjusted odds ratio, 15.62; 95% CI, 2.25-108.48; P=.005) compared with those without, after adjusting for relevant confounders.
CONCLUSION(S): Polycystic ovary syndrome increases the incidence of adverse pregnancy outcomes after FET cycles. Our study suggests women with PCOS may warrant further monitoring and additional counseling before and during pregnancy.
确定多囊卵巢综合征（PCOS）是否会增加接受冷冻胚胎移植（FET）的女性出现不良妊娠和分娩结局的风险。
回顾性队列研究。使用倾向得分匹配法将PCOS组与对照组人群按1:2进行匹配。
不适用。
在8年期间，对2015年1月至2022年12月在瑞金医院生殖医学中心接受FET并分娩的2955名年龄在20至40岁之间的患者进行了不良妊娠结局评估。
无。
评估所有患者的特定妊娠并发症和分娩结局，并进行亚组分析以比较有和没有高雄激素血症的PCOS患者。
在总体倾向得分匹配分析中，PCOS女性出现妊娠期糖尿病的比例更高（24.9%对16.4%；相对风险[RR]，1.51；95%置信区间[CI]，1.26 - 1.82；P <.001）、妊娠期高血压（12.2%对8.9%；RR，1.37；95% CI，1.05 - 1.80；P =.022）、胎膜早破（7.0%对3.6%；RR，1.92；95% CI，1.29 - 2.86；P =.001）、宫颈长度缩短（1.8%对0.4%；RR，8.39；95% CI，1.56 - 12.49；P =.002）、大于胎龄儿（17.4%对13.7%；RR，1.27；95% CI，1.02 - 1.57；P =.032）和低出生体重（19.9%对16.0%；RR，1.25；95% CI，1.02 - 1.52；P =.030）。在单胎妊娠中，PCOS患者的新生儿早产<37周的风险更高（10.5%对6.6%；RR，1.59；95% CI，1.12 - 2.26；P =.009）。在调整相关混杂因素后，有高雄激素血症的PCOS患者与没有的患者相比，宫颈长度缩短的发生率更高（5.5%对0.5%；调整后的优势比，15.62；95% CI，2.25 - 108.48；P =.005）。
多囊卵巢综合征会增加FET周期后不良妊娠结局的发生率。我们的研究表明，PCOS女性在妊娠前和妊娠期间可能需要进一步监测和额外咨询。
