不同体重指数多囊卵巢综合征对围产结局的影响

Effect of Different Body Mass Index Polycystic Ovary Syndrome on Perinatal Outcomes

目的:分析不同体重指数(BMI)多囊卵巢综合征(PCOS)对围产结局的影响。方法:选取2016年4月-2018年1月在本院进行系统产前检查并分娩的PCOS病史孕妇126例,根据BMI将PCOS病史孕妇分为肥胖组(BMI≥24 kg/m^2)及非肥胖组(BMI<24 kg/m^2),各63例,另选取同期60例健康孕妇为对照组。在妊娠中期产检时,检测所有孕妇的血清空腹血糖(FPG)、口服75 g葡萄糖后1、2 h血糖、空腹胰岛素(FINS),计算胰岛素抵抗指数(HOMA-IR),定期随访,记录妊娠、分娩及新生儿情况。结果:肥胖组与非肥胖组的FPG及服糖后1、2 h血糖水平、FINS、HOMA-IR均高于对照组,且肥胖组上述指标均高于非肥胖组,差异均有统计学意义(P<0.05);肥胖组与非肥胖组的阴道顺产率均低于对照组、剖宫产率均高于对照组,且肥胖组阴道顺产率低于非肥胖组、剖宫产率高于非肥胖组,差异均有统计学意义(P<0.05);肥胖组与非肥胖组妊娠并发症发生率、巨大儿发生率均高于对照组,且肥胖组均高于非肥胖组,差异均有统计学意义(P<0.05)。结论:超重PCOS者的围产结局较差,胰岛素抵抗程度严重,临床对于此类孕妇应重视控制体重,积极预防并发症,提高人口质量。

Objective:To analyze the effect of different body mass index(BMI)polycystic ovary syndrome(PCOS)on perinatal outcomes.Method:A total of 126 pregnant women with history of PCOS who underwent systematic prenatal examination and delivered in our hospital from April 2016 to January 2018 were selected,according to BMI,pregnant women with history of PCOS were divided into obese group(BMI≥24 kg/m^2) and non-obese group(BMI<24 kg/m^2),63 cases in each group,and 60 healthy pregnant women in the same period were selected as control group.During the second trimester of pregnancy,the serum fasting blood glucose(FPG),fasting insulin(FINS)and blood glucose at 1 and 2 hours after oral administration of 75 g of glucose were measured in all pregnant women,the insulin resistance index(HOMA-IR)was calculated,followed up regularly,and the pregnancy,delivery and neonatal status were recorded.Result:The levels of FPG,blood glucose at 1 and 2 hours after oral glucose,FINS and HOMA-IR in obese and non-obese groups were higher than those of control group,and the above indexes in obese group were higher than those of non-obese group,the differences were statistically significant(P<0.05).The vaginal spontaneous rate in obese and non-obese groups were lower than those of control group,the cesarean section rate were higher than those of control group,and the vaginal spontaneous rate in obese group was lower than that of non-obese group and cesarean section rate was higher than that of non-obese group,the differences were statistically significant(P<0.05).The incidence of pregnancy complications and macrosomia in obesity and non-obesity groups were higher than those of control group,and obesity group were higher than those of non-obesity group,the differences were statistically significant(P<0.05).Conclusion:The obese PCOS patients have the poor perinatal outcomes and serious insulin resistance,therefore,the PCOS patients shall attach importance to the body weight control to actively prevent the gestational complications and improve the population quality.