非超重／肥胖多囊卵巢综合征合并妊娠孕妇的临床特点及围产结局

目的 研究非超重／肥胖多囊卵巢综合征(PCOS)合并妊娠孕妇的临床特点及围产结局.方法 对2008年5月至2010年7月北京妇产医院产科门诊初次就诊孕妇进行PCOS史的筛查,将61例孕前体质量指数(BMI) ＜24 kg/m2的PCOS单胎孕妇作为研究组,对照组按年龄及孕前体质指数和研究组进行2:1配对,将122例符合条件的非PCOS孕妇纳入对照组,随访两组的妊娠经过直到分娩.多胎妊娠、原有高血压、糖尿病、高脂血症、甲状腺功能异常、心脏病、肾脏病等慢性疾病者未纳入本研究.结果 PCOS组孕妇的血清总胆固醇、甘油三酯、低密度脂蛋白胆固醇水平明显高于对照组;PCOS组妊娠期糖尿病,子痫前期的发生率分别为27.9％( 17/61)、13.1％ (8/61),明显高于对照组15.6％(19/122)、1.6％(2/122),两组差异有统计学意义(P ＜0.05,＜0.01).妊娠期高血压、羊水过多、羊水过少、胎膜早破、胎盘早剥等妊娠并发症及新生儿并发症的发生率,两组比较差异无统计学意义(P＞0.05).结论 孕前BMI ＜24 kg/m2 PCOS患者妊娠后妊娠期糖尿病、子痫前期发生的危险性仍显著增高,独立于肥胖,似乎PCOS本身对此发挥了重要的影响.

Clinical characteristics and perinatal outcomes of non-overweight/obese pregnant women with polycystic ovary syndrome

Objective To determine clinical characteristics and perinatal outcomes of non overweight/obese ( pre-pregnancy body mass index BMI ＜ 24 kg/m2 ) pregnant women with polycystic ovary syndrome (PCOS).Methods The screening of PCOS was performed when they were at first prenatal visit in Beijing Obstetrics and Gynecology Hospital,Capital Medical University from May,2008 to July,2010.61 PCOS women of pregnancy women with BMI ＜ 24 kg/m2 were considered as the study subjects,and 122 pregnant women without PCOS matched by age and pre-pregnancy body mass index (BMI) were selected as the control ones.Patients with history of pre-pregnancy diabetes,hypertension,cardiovascular disease,renal diseases and multiple pregnancies were excluded from the study.We followed pregnancy outcomes of two groups until delivery.Results Significantly higher total cholesterol,triglycerides concentrations and low density lipoprotein cholesterol concentrations were found in the PCOS group than in the controls.PCOS women with BMI ＜ 24 kg/m2 had significantly higher rates of GDM ( 27.9％ ( 17/61 ) ) and pre-eclampsia ( 13.1％ (8/61) ) compared with the controls ( 15.6％ ( 19/122 ),1.6％ (2/122)),P ＜ 0.05,＜ 0.01,respectively.No statistical significance was found in prevalence of pregnancy-induced hypertension,polyhydramnios,oligohydramnios,macrosomia,premature rupture of membranes,placental abruption,macrosomia,fetal death and neonatal congenital abnormality between the two groups ( all P ＞ 0.05 ).Conclusions It is at increased risk of GDM and pre-eclampsia in non-overweight/obese PCOS women,this risk seemed to be due to PCOS itself rather than obesity.