PCOS孕妇不同体质量指数与甲状腺功能异常相关性研究

Study on correlation between different body mass indices and thyroid dysfunction in pregnant women with PCOS

目的研究多囊卵巢综合征(Polycystic Ovary Syndrome,PCOS)孕妇不同体质量指数与甲状腺功能异常的关系。方法选择2017年1月—2024年2月于本院进行定期产检且能追踪到分娩结局的产妇338例作为研究对象。根据产妇孕前是否合并PCOS,将其分为PCOS组(138例)与非PCOS组(200例)两组。根据产妇孕前体质指数将其分为低BMI组(BMI<18.5 kg/m^(2))、正常BMI组(18.5 kg/m^(2)≤BMI<24.0 kg/m^(2))、高BMI组(BMI≥24.0 kg/m^(2))三组。分析PCOS组与非PCOS组患者孕前不同BMI分组比例关系,PCOS组与非PCOS组患者孕前不同BMI分组与甲状腺功能异常关系,PCOS组患者孕前不同BMI分组与母儿并发症及分娩结局关系,PCOS组与非PCOS组患者甲状腺功能异常与妊娠并发症关系。结果低BMI组中,PCOS患者占比显著低于非PCOS患者;高BMI组中,PCOS患者占比显著高于非PCOS患者。PCOS患者甲功异常发生率明显多于非PCOS患者;其中,正常BMI组与高BMI组中,PCOS患者甲功异常发生率明显多于非PCOS患者。甲功异常、GDM及妊高症的发生率在低BMI组、正常BMI组与高BMI组中逐渐递增。与正常BMI组比较,高BMI组甲功异常、妊娠期糖尿病及妊高症的发生率显著升高。PCOS组中GDM合并甲功异常、妊高症合并甲功异常的人数占比显著高于非PCOS组,差异有统计学意义(P<0.05)。结论PCOS患者孕前BMI越高,发生孕期甲状腺功能异常的风险越大。密切关注PCOS患者孕前BMI水平对甲状腺功能异常诊断与治疗具有重要意义,提高PCOS孕妇生活质量。

Objective To investigate the relationship between different body mass indices and thyroid dysfunction in pregnant women with polycystic ovary syndrome(PCOS).Methods 338 postpartum women who underwent regular prenatal checkups in the hospital from January 2017 to February 2024 and were able to track delivery outcomes were included in this study.According to whether the parturient had PCOS before pregnancy,they were divided into a PCOS group(n=138 cases)and a non-PCOS group(n=200 cases).According to the body mass index before pregnancy,parturients were divided into a low BMI group(BMI<18.5 kg/m^(2)),a normal BMI group(18.5≤BMI<24.0 kg/m^(2)),and a high BMI group(BMI≥24.0 kg/m^(2)).Using chi-square test to analyze the proportion of different BMI groups before pregnancy between the PCOS group and non-PCOS group patients,the relationship between different BMI groups before pregnancy and thyroid dysfunction in the PCOS group and non-PCOS group patients,the relationship between different BMI groups before pregnancy and maternal and fetal complications and delivery outcomes in the PCOS group patients,and the relationship between thyroid dysfunction and pregnancy complications in the PCOS and non-PCOS group patients.Results The proportion of PCOS patients in the low BMI group was significantly lower than that of non-PCOS patients;in the high BMI group,the proportion of PCOS patients was significantly higher than that of non-PCOS patients.The incidence of abnormal thyroid function in PCOS patients was significantly higher than that in non-PCOS patients;among them,the incidence of abnormal thyroid function in PCOS patients was significantly higher than that in non-PCOS patients in the normal BMI group and high BMI group.The incidence of abnormal thyroid function,gestational diabetes mellitus(GDM),and preeclampsia gradually increased in the low BMI group,normal BMI group,and high BMI group.Compared with the normal BMI group,the incidence of abnormal thyroid function,GDM,and pregnancy-induced hypertension in the high BMI group was significantly higher.The proportion of GDM combined with abnormal thyroid function,preeclampsia combined with abnormal thyroid function in the PCOS group was significantly higher than that in the non-PCOS group.The difference was statistically significant Conclusions The higher the pre-pregnancy BMI of PCOS patients,the greater the risk of developing thyroid dysfunction during pregnancy.Closely monitoring the pre-pregnancy BMI levels of PCOS patients is of great significance for the diagnosis and treatment of thyroid dysfunction and improving the quality of life of PCOS pregnant women.