多囊卵巢综合征患者发生不良妊娠结局的危险因素分析  

Analysis of risk factors of adverse pregnancy outcome in patients with polycystic ovarian syndrome

作　　者：龚俊媚 万凌屹[1] GONG Junmei;WAN Lingyi(Department of Reproductive Medicine,Hangzhou Red Cross Hospital,Hangzhou 310000,China)

机构地区：[1]杭州市红十字会医院生殖医学科,浙江杭州310000

出　　处：《中国现代医生》2022年第18期183-186,共4页China Modern Doctor

基　　金：浙江省中医药科技计划项目(2018ZA096);杭州市科技发展计划项目(20191203B131)。

摘　　要：目的探讨多囊卵巢综合征(PCOS)患者发生不良妊娠结局的相关危险因素,为临床早期管理和干预提供依据。方法选取2019年6月~2020年10月在杭州市红十字会医院生殖医学科收治的244例PCOS患者进行随访调查,根据随访调查结果,将其分为不良妊娠结局组(101例)和对照组(143例);比较两组间的年龄、孕前体质量指数、PCOS家族史、妊娠高血压、妊娠糖尿病、高雄性激素血症、高LH血症、铁代谢异常、胰岛素抵抗指数、促卵泡素、孕酮、雌二醇、同型半胱氨酸、叶酸等因素;采用逐步Logistic回归法筛选影响PCOS患者发生不良妊娠结局的危险因素。结果244例妊娠PCOS患者不良妊娠结局发生率为41.39%(101/244);影响PCOS患者发生不良妊娠结局的危险因素包括孕前体质量指数(OR=4.023)、妊娠糖尿病(OR=2.743)、高雄性激素血症(OR=4.778)、高LH血症(OR=3.449)、铁代谢异常(OR=4.116)、胰岛素抵抗指数(OR=5.382)等。结论妊娠PCOS患者不良妊娠结局发生率高达40%以上,且影响其发生不良妊娠结局的高危因素较多,PCOS患者成功妊娠后应尽早进行系统管理和干预治疗,降低不良妊娠结局发生率。Objective To investigate the risk factors of adverse pregnancy outcomes in patients with polycystic ovarian syndrome(PCOS)and provide the basis for early clinical management and intervention.Methods A total of 244 PCOS patients admitted to the Department of Reproductive Medicine in Hangzhou Red Cross Hospital from June 2019 to October 2020 were selected for a follow-up survey and divided into the adverse pregnancy outcome group(101 cases)and the control group(143 cases)according to the follow-up survey results.The age,pre-pregnancy body mass index,family history of PCOS,pregnancy-induced hypertension,gestational diabetes,hyperandrogenism,high luteinizing hormone in the blood,abnormal iron metabolism,insulin resistance index,follicle-stimulating hormone,progesterone,estradiol,homocysteine,folic acid,and other factors were compared between the two groups.Stepwise logistic regression was used to screen the risk factors affecting adverse pregnancy outcomes in PCOS patients.Results The incidence of adverse pregnancy outcomes in 244 pregnant PCOS patients was 41.39%(101/244).The risk factors affecting adverse pregnancy outcomes in PCOS patients included pre-pregnancy body mass index(OR=4.023),gestational diabetes(OR=2.743),hyperandrogenism(OR=4.778),high luteinizing hormone in the blood(OR=3.449),abnormal iron metabolism(OR=4.116),and insulin resistance index(OR=5.382).Conclusion The incidence of adverse pregnancy outcomes in pregnant PCOS patients is more than 40%.Many factors are affecting adverse pregnancy outcomes.Systematic management and intervention should be performed as soon as possible after successful pregnancy in PCOS patients to reduce the incidence of adverse pregnancy outcomes.

关 键 词：多囊卵巢综合征 妊娠 妊娠结局 危险因素 

分 类 号：R711.75[医药卫生—妇产科学] R714[医药卫生—临床医学]