目的:研究多囊卵巢综合征(PCOS)患者不良妊娠结局的风险,并检查高雄激素血症的作用。
方法:队列研究。
方法:在1997-2010年期间在一家私人生育诊所发现的PCOS女性单例妊娠,背景人群包括Hvidovre医院的所有单例分娩,丹麦,2005年。
方法:459名PCOS女性和5409名女性背景人群。
方法:从丹麦国家注册中提取产科结局,并通过多元logistic回归分析计算优势比(OR)。调整年龄,奇偶校验,和体重指数。
方法:先兆子痫的风险,早产,在整个PCOS人群和高雄激素血症的子样本中,胎龄后代较小。
结果:患有PCOS的女性在妊娠37周时早产的风险增加(OR2.28;95%置信区间,95%CI,1.51-3.45;P<0.0001)。升高的风险仅限于患有PCOS的高雄激素女性:妊娠37周前早产(OR2.78;95%CI1.62-4.77;P<0.0001),并且在患有PCOS的正常雄激素女性中未发现(OR1.35;95%CI0.54-3.39;P=0.52)。与背景人群相比,先兆子痫的总体风险并未升高(OR1.69;95%CI0.99-2.88;P=0.05)。但在高雄激素亚样本中显著增加(OR2.41;95%CI1.26-4.58;P<0.001)。在所有组中,小于胎龄后代的风险相似。
结论:与背景人群相比,患有PCOS的女性早产风险增加。增加的风险仅限于患有PCOS的高雄激素女性,其早产和先兆子痫的风险增加了两倍。
OBJECTIVE: To study the risk of adverse pregnancy outcomes in women with polycystic ovary syndrome (PCOS), and to examine the role of
hyperandrogenaemia.
METHODS: Cohort study.
METHODS: Singleton pregnancies in women with PCOS identified at a private fertility clinic during 1997-2010 and a background population including all singleton deliveries at Hvidovre Hospital, Denmark, in 2005.
METHODS: A cohort of 459 women with PCOS and a background population of 5409 women.
METHODS: Obstetric outcomes were extracted from national Danish registries and odds ratios (ORs) were calculated by multiple logistic regression analysis, adjusting for age, parity, and body mass index.
METHODS: Risk of pre-eclampsia, preterm delivery, and small for gestational age offspring in the entire PCOS population and in a subsample with
hyperandrogenaemia.
RESULTS: Women with PCOS had an increased risk of preterm delivery <37 weeks of gestation (OR 2.28; 95% confidence interval, 95% CI, 1.51-3.45; P < 0.0001). The elevated risk was confined to hyperandrogenic women with PCOS: preterm delivery before 37 weeks of gestation (OR 2.78; 95% CI 1.62-4.77; P < 0.0001), and was not seen in normoandrogenic women with PCOS (OR 1.35; 95% CI 0.54-3.39; P = 0.52). The overall risk of pre-eclampsia was not elevated (OR 1.69; 95% CI 0.99-2.88; P = 0.05) compared with the background population, but was significantly increased in the hyperandrogenic subsample (OR 2.41; 95% CI 1.26-4.58; P < 0.001). The risk of small for gestational age offspring was similar in all groups.
CONCLUSIONS: Women with PCOS had an increased risk of preterm delivery compared with the background population. The increased risk was confined to hyperandrogenic women with PCOS who had a two-fold increased risk of preterm delivery and pre-eclampsia.