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[高雄激素血症对多囊卵巢综合征女性体外受精单胎妊娠产科并发症的影响]

[Effect of hyperandrogenism on obstetric complications of singleton pregnancy from in vitro fertilization in women with polycystic ovary syndrome].

作者信息

Wei D M, Zhang Z Z, Wang Z, Li P, Wang J F, Liu Y J, Zhang J T, Shi Y H

机构信息

Reproductive Endocrinology Department, The Center for Reproductive Medicine, Shandong University, Jinan 250021, China.

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2018 Jan 25;53(1):18-22. doi: 10.3760/cma.j.issn.0529-567X.2018.01.005.

Abstract

To compare the difference in risks of obstetric complications of singleton pregnancy between women with hyperandrogenic polycystic ovary syndrome (PCOS) and women with normoandrogenic PCOS. Prospective cohort study. This study was a secondary analysis of data collected during a multicenter randomized controlled clinical trial. Women who got clinical singleton pregnancy were grouped according to whether they were diagnosed with hyperandrogenism at baseline. There were 118 women with hyperandrogenism and 366 women without hyperandrogenism. The incidences of obstetric complications and birth weight were compared between the two groups. Women with hyperandrogenic PCOS had a significantly higher risk of preterm delivery than women with normoandrogenic PCOS [12.7% (15/118) versus 3.6% (13/366); 3.94, 95% 1.82-8.56]. After adjustment of age, duration of infertility, body mass index, and fresh or frozen embryo transfer group, hyperandrogenism was still associated with an increased risk of preterm delivery (3.67, 95% 1.67-8.07). Compared with women with normoandrogenic PCOS, women with hyperandrogenic PCOS had similar risks of pregnancy loss, gestational diabetes mellitus, pre-eclampsia, placenta previa, and postpartum hemorrhage (all 0.05). Birth weight as well as the risks of being small for gestational age and large for gestational age were also comparable between the two groups (all 0.05). In women with PCOS and singleton pregnancy, those with preconceptional hyperandrogenism have a higher risk of preterm delivery than those without hyperandrogenism.

摘要

比较高雄激素性多囊卵巢综合征(PCOS)女性与正常雄激素性PCOS女性单胎妊娠产科并发症风险的差异。前瞻性队列研究。本研究是对一项多中心随机对照临床试验收集的数据进行的二次分析。将临床单胎妊娠的女性根据基线时是否被诊断为高雄激素血症进行分组。有118名高雄激素血症女性和366名无高雄激素血症女性。比较两组产科并发症的发生率和出生体重。高雄激素性PCOS女性的早产风险显著高于正常雄激素性PCOS女性[12.7%(15/118)对3.6%(13/366);3.94,95%可信区间1.82 - 8.56]。在调整年龄、不孕持续时间、体重指数以及新鲜或冷冻胚胎移植组后,高雄激素血症仍与早产风险增加相关(3.67,95%可信区间1.67 - 8.07)。与正常雄激素性PCOS女性相比,高雄激素性PCOS女性的妊娠丢失、妊娠期糖尿病、子痫前期、前置胎盘和产后出血风险相似(均P>0.05)。两组之间的出生体重以及小于胎龄儿和大于胎龄儿的风险也相当(均P>0.05)。在PCOS单胎妊娠女性中,孕前高雄激素血症者的早产风险高于无高雄激素血症者。

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