目的:本研究的目的是调查妊娠的潜在差异,delivery,育龄期妇女中两种高雄激素疾病的新生儿结局;多囊卵巢综合征(PCOS)和先天性肾上腺增生(CAH)。
方法:回顾性基于人群的研究,数据来自2004年至2014年的全国住院患者样本数据库(HCUP-NIS)。
方法:14,881例多囊卵巢综合征(PCOS)和298例先天性肾上腺增生(CAH)。
方法:妊娠期糖尿病,前置胎盘,妊娠高血压,妊娠期高血压,先兆子痫,子痫,先兆子痫和子痫叠加高血压,早产,早产胎膜早破,胎盘早剥,绒毛膜羊膜炎,交货方式,产妇感染,子宫切除术,输血,静脉血栓栓塞(妊娠期深静脉血栓形成和肺栓塞,产时,或产后),产妇死亡,绒毛膜羊膜炎,临产期间败血症,产后子宫内膜炎,脓毒性骨盆,腹膜炎,小于胎龄,先天性异常,胎儿宫内死亡。
结果:在调整了潜在的混杂因素后,我们发现与CAH女性相比,PCOS女性患妊娠高血压(调整后OR=1.76;95%CI:1.12-2.77;p=0.015)和妊娠糖尿病(调整后OR=1.68;95%CI:1.12-2.52;p=0.012)的风险增加。相反,CAH患者经剖宫产分娩的风险增加(校正OR0.59;95%CI:0.44-0.80;p<0.001),小于胎龄新生儿(校正OR0.32;95%CI:0.20-0.52;p<0.001)。
结论:本研究首次直接比较PCOS和CAH患者的产科和新生儿结局。尽管有相似的表型和一些常见的激素和生化特征,如胰岛素抵抗,高胰岛素血症,和高雄激素血症,我们的研究结果提示存在与妊娠并发症的发病机制有关的其他代谢途径.
OBJECTIVE: To investigate potential differences in pregnancy, delivery, and neonatal outcomes between 2 hyperandrogenic conditions in reproductive-aged women: polycystic ovary syndrome (PCOS) and congenital adrenal hyperplasia (CAH).
METHODS: Retrospective population-based study with data from the Health Care Cost and Utilization Project-Nationwide Inpatient Sample Database from 2004-2014.
METHODS: Not applicable.
METHODS: A total of 14,881 women with PCOS and 298 women with CAH.
METHODS: Not applicable.
METHODS: Gestational diabetes mellitus, placenta previa, pregnancy-induced hypertension (HTN), gestational HTN, preeclampsia, eclampsia, preeclampsia and eclampsia superimposed on HTN, preterm birth, preterm premature rupture of membrane, abruptio placenta, chorioamnionitis, mode of delivery, maternal infection, hysterectomy, blood transfusion, venous thromboembolism (deep vein thrombosis and pulmonary embolism during pregnancy, intrapartum, or postpartum), maternal death, chorioamnionitis, septicemia during labor, postpartum endometritis, septic pelvic, peritonitis, small for gestational age, congenital anomalies, and intrauterine fetal demise.
RESULTS: After adjusting for potential confounders, we found that women with PCOS were at increased risk of developing pregnancy-induced HTN (adjusted odds ratio [OR] = 1.76; 95% confidence interval [CI]: 1.12-2.77) and gestational diabetes (adjusted OR = 1.68; 95% CI: 1.12-2.52) when compared with women with CAH. Contrary women with CAH were at increased risk for delivery via cesarean section (adjusted OR = 0.59; 95% CI: 0.44-0.80) and small for gestational age neonates (adjusted OR = 0.32; 95% CI: 0.20-0.52).
CONCLUSIONS: To our knowledge, this study is the first to directly compare obstetric and neonatal outcomes between patients with PCOS and CAH. Despite the similar phenotypes and some common hormonal and biochemical profiles, such as insulin resistance, hyperinsulinemia, and hyperandrogenism, our results suggest the existence of additional metabolic pathways implicated in the pathogenesis of pregnancy complications.