孕前体重指数对多囊卵巢综合征患者妊娠结局的影响  

Effects of pre-pregnancy body mass index on pregnancy outcomes of women with polycystic ovarian syndrome

作　　者：聂明月 于松[1] 杨晓葵[1] 

机构地区：[1]首都医科大学附属北京妇产医院生殖医学科,北京100026

出　　处：《中国优生与遗传杂志》2014年第12期67-69,共3页Chinese Journal of Birth Health & Heredity

基　　金：国家自然科学基金项目(81170542);北京市卫生系统高层次人才培养项目(2011-3-071);首都医科大学附属北京妇产医院学科带头人项目(2013-2)

摘　　要：目的比较不同体重指数对多囊卵巢综合征（polycystic ovarian syndrome，PCOS）患者妊娠结局和新生儿结局的影响。方法回顾性分析2011年1月至2013年12月于首都医科大学附属北京妇产医院产科就诊的PCOS孕妇328例，按照孕前体重指数（body mass index，BMI）分为体重正常组（BMI 18．5～24．9kg／m^2）和超重及肥胖组（BMI≥25．0kg／m^2），比较两组PCOS孕妇妊娠结局及新生儿结局等情况。结果超重及肥胖组的既往流产率和辅助生殖技术助孕妊娠比例、妊娠期糖尿病、妊娠期高血压疾病和胎盘早剥的发生率显著高于正常体重组（P〈0．05）；两组问胎膜旱破、胎儿生长受限、前置胎盘和产后出血等并发症无统计学差异（P〉0．05）；在分娩方式上，超重及肥胖PCOS孕妇与对照组相比顺产率低而剖宫产率高，早产和巨大儿的发生率也显著增加，差异具有统计学意义（P〈0．05）。结论孕前超重及肥胖的PCOS患者发生妊娠期并发症的风险增高，新生儿容易出现不良结局，对这类患者应加强健康管理，孕前即注意体重的控制以改善母婴结局。Objective： To explore the influence of body mass index （BMI） on pregnancy and neonatal outcomes in polycystic ovarian syndrome （PCOS） pregnant women. Method： A retrospective study involved 328 PCOS patients was conducted in our hospital from January 2011 to December 2013. The pregnancy and neonatal outcomes were analyzed according to different BMI ranges： 18.5kg/m^2≤BMI〈24.9kg/m^2 and BMI≥25.0kg/m^2. Results： Significant differences in miscarriage rate and assisted reproductive technology （ART） rate were observed between overweight/obese patients and normal weight PCOS patients. The rate of gestational diabetes mellitus （GDM） , hypertensive disorder complicating pregnancy （HDCP） and placental abmption in the overweight/obese group were higher than that in the control group （P〈0.05） . There was no significant difference in the rates of premature rupture of fetal membranes, fetal growth restriction （FGR） , placenta praevia and postpartum hemorrhage between the two groups （P〉0.05） . The results also showed significant higher rates in Cesarean section, preterm delivery and fetal macrosomia. Conclusion： The overweight and obese PCOS women have higher risks of pregnancy complications and adverse neonatal outcomes. In order to enhance the maternal and neonatal outcomes, the pre-pregnancy BMI should be suitably controlled and the pregnancy management should be strengthened.

关 键 词：多囊卵巢综合征 妊娠并发症 新生儿结局 体重指数 

分 类 号：R711.75[医药卫生—妇产科学]