多囊卵巢综合征伴胰岛素抵抗对妊娠结局的临床影响研究

目的:旨对多囊卵巢综合征(PCOS)伴胰岛素抵抗(IR)对妊娠结局的临床影响进行系统研究。方法:选择2012年1月至2016年1月间笔者单位就诊的65例PCOS患者作为临床研究资料,且将胰岛素抵抗指数(HOMA-IR)≥2.77的30例PCOS伴IR患者作为P-I组;剩余35例PCOS患者作为对照组;分析两组患者新生儿情况以及妊娠合并症、并发症等情况。结果:P-I组患者流产、巨大儿、早产发生率明显高于对照组(P0.05);但两组患者宫内胎儿生长受限(FGR)、死胎发生率无明显差异(P0.05);另外,P-I组患者胎膜早破、GDM、霉菌性阴道炎发生率明显高于对照组(P0.05);但两组患者羊水过多、妊娠期高血压发生率无明显差异(P0.05)。结论:PCOS伴IR患者不良妊娠结局发生率明显高于单纯PCOS患者;因此,加强对孕妇进行妊娠筛查,提高PCOS治疗效果对全面降低不良妊娠结局具有积极的现实意义。

Clinical effect of polycystic ovary syndrome with insulin resistance on pregnancy outcome

Objectives:To investigate the clinical effect of polycystic ovary syndrome (PCOS) with insulin resistance (IR) on pregnancy outcome.Methods:65 patients with PCOS treated in our hospital from January 2012 to January 2016 were selected.30 patients with PCOS and IR with insulin resistance index (HOMA-IR) ≥2.77 were selected as P-I group;the remaining 35 PCOS patients were as control group;newborns status and complications of pregnancy,complications and so on of two groups were compared.Results:The incidence rates of miscarriage,macrosomia and preterm delivery in P-I group were significantly higher than these in control group,with significant differences (P ＜ 0.05).However,the incidence of fetal growth retardation (FGR) and stillbirth had no significant difference (P ＞ 0.05).The incidence of premature rupture of membranes,GDM and mycotic vaginitis in P-I group were significantly higher than these in control group (P ＜ 0.05).But the incidence of hypertension between the two groups had no significant difference (P ＞ 0.05).Conclusion:The incidence of adverse pregnancy outcomes in patients with PCOS and IR is significantly higher than that in patients with PCOS alone.Therefore,it is of great significance to strengthen the screening of pregnant women and improve the effect of PCOS on the overall reduction of adverse pregnancy outcome.