多囊卵巢综合征患者妊娠结局与孕前 BMI 及孕期体质量增长的相关性

Pregnancy outcome and pre-pregnancy BMI and weight gain in pregnancy in patients with polycystic ovary syndrome

目的:探讨多囊卵巢综合征(PCOS)患者临床妊娠后结局与孕前BMI及孕期体质量增长的相关性。方法:采用前瞻性的研究设计,以中山市博爱医院生殖中心2017年5月~2019年2月接诊的PCOS病例并于2019年12月前追踪到妊娠结局者为研究对象。跟踪孕期体质量增长情况,随访妊娠结局。结果:PCOS患者孕前BMI超重或肥胖组的GDM、巨大儿发生率均高于孕前BMI正常组(P<0.05)。对于PCOS患者孕前BMI正常组,增重>16 kg组妊娠高血压、妊娠期糖尿病(GDM)、巨大儿、早产、出生窒息发生率高于增重≤16 kg组(P<0.05)。对于PCOS患者孕前BMI超重或肥胖组,增重>11.5 kg组妊娠高血压、GDM的发生率高于增重≤11.5 kg组(P<0.05)。结论:PCOS患者孕前BMI越高,发生不良妊娠结局风险越大。按照PCOS患者的孕前BMI水平对孕期体质量增长范围进行控制可预防不良妊娠结局。

Objective:To investigate the correlation between the outcome of clinical pregnancy in patients with polycystic ovary syndrome(PCOS)and pre-pregnancy BMI and weight gain during pregnancy.Methods:Prospective study was performed in PCOS patients admitted to the reproductive center of our hospital between May 2017 and February 2019.The pregnancy outcome was documented by December 2019.Weight gain during pregnancy and pregnancy outcomes were followed.Results:The incidence of gestational diabetes mellitus(GDM)and macrosomia in the PCOS group were higher than that in the control group(P<0.05).For PCOS patients with normal pre-pregnancy BMI,the incidence of pregnancy hypertension,GDM,macrosomia,preterm birth and birth asphyxia was higher in women with weight gain>16 kg group than in those with that≤16 kg group(P<0.05),and for PCOS patients with high pre-pregnancy BMI,the incidence of gestational hypertension and GDM in the weight gain>11.5 kg group was higher than that of≤11.5 kg group(P<0.05).Conclusion:The higher BMI of PCOS patients before pregnancy,the greater risk of adverse pregnancy outcome will be.The findings suggest that controlling weight gain during pregnancy by pre-pregnancy BMI can prevent adverse pregnancy outcomes in women with PCOS.