不同体质量指数对PCOS患者冻融胚胎移植围产结局及新生儿结局的影响  

Effects of different body mass index on perinatal and neonatal outcomes of frozen-thawed embryo transfer in PCOS patients

作　　者：罗桂英[1] 程静娴 王春艳[1] 王婕妤 袁兰兰[1] 宋林林 吴炫烨 曹云霞[1] Luo Guiying;Cheng Jingxian;Wang Chunyan;Wang Jieyu;Yuan Lanlan;Song Linlin;Wu Xuanye;Cao Yunxia(Reproductive Center of the First Affiliated Hospital of Anhui Medical University,Hefei 230032,China)

机构地区：[1]安徽医科大学第一附属医院生殖中心,合肥230032

出　　处：《中华生殖与避孕杂志》2023年第1期57-63,共7页Chinese Journal of Reproduction and Contraception

基　　金：安徽高校自然科学研究项目(KJ2020A0203);安徽高校人文社会科学研究项目(SK2020A0146)。

摘　　要：目的探讨不同体质量指数(body mass index,BMI)的多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者对冻融胚胎移植围产结局及新生儿结局的影响。方法采用回顾性队列研究,纳入安徽医科大学第一附属医院生殖中心2016年至2020年期间由于PCOS不孕进行冻融胚胎移植、年龄≤35岁且临床妊娠为单胎的患者临床资料,共1481个周期,根据BMI值分为4组,偏瘦组75个周期(BMI<18.5 kg/m^(2)),正常体质量组793个周期(18.5 kg/m^(2)≤BMI<24.0 kg/m^(2)),超重组468个周期(24.0 kg/m^(2)≤BMI<28.0 kg/m^(2)),肥胖组145个周期(BMI≥28.0 kg/m^(2)),比较各组一般资料、促排卵情况、围产结局以及新生儿结局的差别。结果相较于超重组、正常体质量组和偏瘦组,肥胖组的早期流产率最高[23.4%(34/145)比15.8%(74/468)比14.0%(111/793)比9.3%(7/75),P=0.014],活产率最低[68.3%(99/145)比76.7%(359/468)比79.7%(632/793)比88.0%(66/75),P=0.003]。肥胖组和超重组的妊娠期糖尿病发病率[6.9%(10/145)、4.5%(21/468)]高于正常体质量组[2.3%(18/793),肥胖组比正常体质量组P=0.005,超重组比正常体质量组P=0.028]肥胖组和超重组的剖宫产率[81.8%(81/99)、74.9%(269/359)]高于正常体质量组和偏瘦组[67.6%(427/632)、57.6%(38/66),肥胖组比正常体质量组P=0.005,肥胖组比偏瘦组P=0.001,超重组比正常组P=0.015,超重组比偏瘦组P=0.004],巨大儿出生率[18.2%(18/99)、15.6%(56/359)]也高于正常体质量组和偏瘦组[10.1%(64/632)、6.1%(4/66),肥胖组比正常体质量组P=0.018,肥胖组比偏瘦组P=0.025,超重组比正常组P=0.011,超重组比偏瘦组P=0.041]。各组在晚期流产率、妊娠期高血压、宫外孕以及新生儿的早产率、Apgar评分、身高、出生缺陷等差异均无统计学意义(均P>0.05)。结论肥胖和超重影响PCOS患者的围产结局和新生儿结局。在临床工作中,需重视PCOS患者的体质量管理。Objective To investigate the influence of polycystic ovary syndrome(PCOS)patients with different body mass index(BMI)on perinatal and neonatal outcomes of frozen-thawed embryo transfer.Methods A retrospective cohort study was performed on the clinical data of patients with PCOS infertility who underwent cryopreservation transplantation in Reproductive Center of the First Affiliated Hospital of Anhui Medical University from 2016 to 2020.The clinical pregnancy was singleton,a total of 1481 cycles were divided into 4 groups according to BMI value.There were 75 cycles in the underweight group(BMI<18.5 kg/m^(2)),793 cycles in the normal weight group(18.5 kg/m^(2)≤BMI<24.0 kg/m^(2)),468 cycles in the overweight group(24.0 kg/m^(2)≤BMI<28.0 kg/m^(2)),145 cycles in the obese group(BMI≥28.0 kg/m^(2)).The differences of general information,perinatal outcome and neonatal outcome were compared among the four groups.Results Compared with the overweight group,the normal weight group and the underweight group,the obesity group had the highest early abortion rate[23.4%(34/145)vs.15.8%(74/468)vs.14.0%(111/793)vs.9.3%(7/75),P=0.014],and the lowest live birth rate[68.3%(99/145)vs.76.7%(359/468)vs.79.7%(632/793)vs.88.0%(66/75),P=0.003].The incidence of gestational diabetes in the obesity group and the overweight group[6.9%(10/145)and 4.5%(21/468)]was higher than that in the normal weight group[2.3%(18/793)](the obesity group vs.the normal weight group P=0.005,the overweight group vs.the normal weight group P=0.028).The rate of cesarean section in the obesity group and the overweight group[81.8%(81/99),74.9%(269/359)]was higher than that in the normal weight group[67.6%(427/632)]and the underweight group[57.6%(38/66),the obesity group vs.the normal weight group P=0.005,the obesity group vs.the underweight group P=0.001,the overweight group vs.the normal weight group P=0.015,the overweight group vs.the underweight group P=0.004].The macrosomia birth rate[18.2%(18/99),15.6%(56/359)]was also higher than that of the normal weight g

关 键 词：多囊卵巢综合征 体质量指数 冻融胚胎移植 围产结局 新生儿结局 

分 类 号：R714.8[医药卫生—妇产科学]