Chang Yi-Ting, Chen Ming-Jer, Lin Wei-Szu, Lin Ching-Heng, Chang Jui-Chun
Department of Obstetrics and Gynecology and Women's Health, Taichung Veterans General Hospital, Taichung 407219, Taiwan.
School of Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan.
J Clin Med. 2024 Dec 28;14(1):123. doi: 10.3390/jcm14010123.
: Women with polycystic ovarian syndrome (PCOS) are at higher risk for pregnancy complications. The PCOS population is heterogeneous, with different phenotypes linked to varying risks of adverse outcomes. However, literature on pre-conceptional hyperandrogenism is limited and based on small sample sizes. : This multi-institutional registry-based retrospective cohort study included pregnant patients diagnosed with PCOS with or without pre-conceptional hyperandrogenism. Utilizing the TriNetX platform, one-to-one propensity score matching was conducted to adjust for confounding factors. Exclusion criteria included multiple pregnancies and patients who received assisted reproductive technology, oral contraceptives, or spironolactone. 571 patients with PCOS and pre-conceptional hyperandrogenism and 13,465 patients with PCOS without hyperandrogenism were identified. Post-propensity matching, each cohort consisted of 564 patients. : Pregnant women diagnosed with PCOS and pre-conceptional hyperandrogenism showed a higher risk of large for gestational age (6.6% vs. 3.9%, OR = 1.73, 95% CI [1.007-2.972], -value = 0.045) and preterm birth (10.3% vs. 5.9%, OR = 1.844, 95% CI [1.183-2.876], -value = 0.006), but had no significant increase in the risk of gestational hypertension, preeclampsia/eclampsia, gestational diabetes, missed abortion, intrauterine growth restriction, placenta abruption, or cesarean section. : Women with PCOS and pre-conceptional hyperandrogenism have an increased risk of pregnancy complications, especially large for gestational age and preterm birth. Further research is needed to clarify the underlying mechanisms, and whether treatment can improve outcomes.
患有多囊卵巢综合征（PCOS）的女性发生妊娠并发症的风险更高。PCOS人群具有异质性，不同的表型与不同的不良结局风险相关。然而，关于孕前高雄激素血症的文献有限且基于小样本量。
这项基于多机构注册的回顾性队列研究纳入了诊断为PCOS且有或无孕前高雄激素血症的孕妇。利用TriNetX平台，进行一对一倾向评分匹配以调整混杂因素。排除标准包括多胎妊娠以及接受辅助生殖技术、口服避孕药或螺内酯的患者。共识别出571例患有PCOS和孕前高雄激素血症的患者以及13465例无高雄激素血症的PCOS患者。倾向评分匹配后，每个队列由564例患者组成。
诊断为PCOS和孕前高雄激素血症的孕妇出现大于胎龄儿的风险更高（6.6%对3.9%，OR = 1.73，95%CI[1.007 - 2.972]，P值 = 0.045）和早产风险更高（10.3%对5.9%，OR = 1.844，95%CI[1.183 - 2.876]，P值 = 0.006），但妊娠期高血压、先兆子痫/子痫、妊娠期糖尿病、稽留流产、胎儿生长受限、胎盘早剥或剖宫产的风险没有显著增加。
患有PCOS和孕前高雄激素血症的女性妊娠并发症风险增加，尤其是大于胎龄儿和早产。需要进一步研究以阐明潜在机制，以及治疗是否能改善结局。
