体质指数对多囊卵巢综合征患者首次冻融胚胎移植妊娠结局的影响

Effect of body mass index on pregnancy outcome of first frozen-thaw embryo transfer in patients with polycystic ovary syndrome

目的分析多囊卵巢综合征(polycystic ovarian syndrome,PCOS)患者体质指数(body mass index,BMI)与冻融胚胎移植(frozen embryo transfer,FET)妊娠结局的关系。方法选取2018年1月至2020年12月在东莞市妇幼保健院生殖中心首次行FET的771例PCOS患者的临床资料进行回顾性分析。根据BMI,分为A组(正常BMI组,BMI 18.0~24.0 kg/m^(2),n=654),B组(高BMI组,BMI>24.0 kg/m^(2),n=117)。比较两组患者的妊娠结局,分析其与BMI的关系。结果在PCOS患者中,与正常BMI组比较,高BMI组患者的早期流产率(24.00%vs 12.11%,χ^(2)=8.908,P=0.012)、早产率(18.18%vs 8.78%,χ^(2)=4.545,P=0.033)、剖宫产率(38.20%vs 18.20%,χ^(2)=11.263,P=0.001)均显著升高,差异有统计学意义。两组患者的胚胎着床率、临床妊娠率、活产率及新生儿出生体重差异无统计学意义。结论PCOS患者过高的BMI可能对FET周期的妊娠结局产生一定的负面影响。

Objective To analyze the relationship between body mass index(BMI)and pregnancy outcome of frozen embryo transfer(FET)in patients with polycystic ovarian syndrome(PCOS).Methods Clinical data of 771 PCOS patients who underwent the first FET circle in the Reproductive Center of Dongguan Maternal&Child Health Hospital from January 2018 to December 2020 were retrospectively analyzed.According to BMI,the patients were divided into Group A(normal BMI group,BMI 18.0~24.0 kg/m^(2),n=654 cases)and Group B(high BMI group,BMI>24.0 kg/m^(2),n=117).The pregnancy outcomes of the two groups were compared,and the relationship between pregnancy outcomes and BMI was analyzed.Results Compared with Group A,the early miscarriage rate(24.00%vs 12.11%,χ^(2)=8.908,P=0.012),premature delivery rate(18.18%vs 8.78%,χ^(2)=4.545,P=0.033)and cesarean section rate(38.20%vs 18.20%,χ^(2)=11.263,P=0.001)in Group B were higher,and the differences were statistically significant.There were no significant differences in embryo implantation rate,clinical pregnancy rate,live birth rate and newborn birth weight between the two groups.Conclusions The increased BMI of PCOS patients may negatively affect the pregnancy outcome of FET cycle.