Polycystic ovarian syndrome (PCOS) disrupts ovulation leading to both infertility and miscarriage;yet, its impact on obstetrical outcomes remains largely uncertain due to conflicting findings. We analyzed data from th...Polycystic ovarian syndrome (PCOS) disrupts ovulation leading to both infertility and miscarriage;yet, its impact on obstetrical outcomes remains largely uncertain due to conflicting findings. We analyzed data from the CDC Pregnancy Risk Assessment of Monitoring System, specifically Standard Core and Phase 8 responses, with 9549 respondents across the United States through SPSS 28 software in this cross-sectional study. Two variables assessed PCOS status in respondents: history of PCOS and PCOS during pregnancy. With a history of PCOS, there were significantly increased odds of diabetic (OR 1.665, p < 0.001), hypertensive disorders (OR 1.589, p < 0.001) during pregnancy, neonatal mortality (OR 1.550, p < 0.001), cesarean section (C/S) (OR 1.489, p < 0.001), and preterm prelabor rupture of membranes (PPROM) (OR 2.081, p < 0.001). With PCOS diagnosed during pregnancy, there were significantly greater odds of diabetes (OR 3.278, p < 0.001), hypertensive disorders (OR 2.935, p < 0.001) during pregnancy, and significantly decreased risk for small for gestational age (2 standard deviations) (OR 0.337, p = 0.024). PCOS is a significant risk factor that contributes to maternal morbidity. Our results support the hypothesis that PCOS’ impact extends well into a woman’s obstetrical journey, with varying degrees of associated adverse maternal and fetal risks. Preliminary pathophysiologic explanations associated with PCOS gestational diabetes include pre-existing insulin resistance. Meanwhile, altered placentation and endovascular changes associated with PCOS secondary to a baseline deranged metabolic environment predispose patients to developing hypertensive disorders, PPROM, and preterm delivery. Associations between neonatal mortality and C/S can be attributed to elevated maternal body mass index. The pathophysiologic link between PCOS and the above obstetrical outcomes still remains unknown, necessitating further investigation;however, this study identifies the outcomes that require the most attention at this time.展开更多
[Objectives] To observe the clinical efficacy of Jiawei Buzhong Yiqi Decoction in the treatment of polycystic ovarian syndrome(PCOS).[Methods]Obese patients with PCOS were recruited for the study in September 2014-Dec...[Objectives] To observe the clinical efficacy of Jiawei Buzhong Yiqi Decoction in the treatment of polycystic ovarian syndrome(PCOS).[Methods]Obese patients with PCOS were recruited for the study in September 2014-December 2016 from Chinese medicine gynecological clinic in the affiliated hospital of Hubei University of Medicine.All these patients were given one dose of Jiawei Buzhong Yiqi Decoction one time a day for three months.Body mass index(BMI) was measured before and after treatment.Sex hormone levels and ovulation were measured,and the improvement of clinical symptoms was compared before and after treatment.[Results] After treatment,the levels of BMI and serum luteinizing hormone(LH),testosterone(T) were significantly decreased,and the level of serum estradiol(E2) was significantly higher than that before treatment.Ovarian enlargement and polycystic changes,menstrual cycle,menstrual flow and menstrual period were improved in varying degrees.[Conclusions] Jiawei Buzhong Yiqi Decoction has a good clinical effect in the treatment of obese PCOS.展开更多
文摘Polycystic ovarian syndrome (PCOS) disrupts ovulation leading to both infertility and miscarriage;yet, its impact on obstetrical outcomes remains largely uncertain due to conflicting findings. We analyzed data from the CDC Pregnancy Risk Assessment of Monitoring System, specifically Standard Core and Phase 8 responses, with 9549 respondents across the United States through SPSS 28 software in this cross-sectional study. Two variables assessed PCOS status in respondents: history of PCOS and PCOS during pregnancy. With a history of PCOS, there were significantly increased odds of diabetic (OR 1.665, p < 0.001), hypertensive disorders (OR 1.589, p < 0.001) during pregnancy, neonatal mortality (OR 1.550, p < 0.001), cesarean section (C/S) (OR 1.489, p < 0.001), and preterm prelabor rupture of membranes (PPROM) (OR 2.081, p < 0.001). With PCOS diagnosed during pregnancy, there were significantly greater odds of diabetes (OR 3.278, p < 0.001), hypertensive disorders (OR 2.935, p < 0.001) during pregnancy, and significantly decreased risk for small for gestational age (2 standard deviations) (OR 0.337, p = 0.024). PCOS is a significant risk factor that contributes to maternal morbidity. Our results support the hypothesis that PCOS’ impact extends well into a woman’s obstetrical journey, with varying degrees of associated adverse maternal and fetal risks. Preliminary pathophysiologic explanations associated with PCOS gestational diabetes include pre-existing insulin resistance. Meanwhile, altered placentation and endovascular changes associated with PCOS secondary to a baseline deranged metabolic environment predispose patients to developing hypertensive disorders, PPROM, and preterm delivery. Associations between neonatal mortality and C/S can be attributed to elevated maternal body mass index. The pathophysiologic link between PCOS and the above obstetrical outcomes still remains unknown, necessitating further investigation;however, this study identifies the outcomes that require the most attention at this time.
基金Supported by Scientific Research Guidance Project of Hubei Provincial Department of Education(B2018437)Scientific Research Guiding Project of Shiyan City,Hubei Province(18Y08)
文摘[Objectives] To observe the clinical efficacy of Jiawei Buzhong Yiqi Decoction in the treatment of polycystic ovarian syndrome(PCOS).[Methods]Obese patients with PCOS were recruited for the study in September 2014-December 2016 from Chinese medicine gynecological clinic in the affiliated hospital of Hubei University of Medicine.All these patients were given one dose of Jiawei Buzhong Yiqi Decoction one time a day for three months.Body mass index(BMI) was measured before and after treatment.Sex hormone levels and ovulation were measured,and the improvement of clinical symptoms was compared before and after treatment.[Results] After treatment,the levels of BMI and serum luteinizing hormone(LH),testosterone(T) were significantly decreased,and the level of serum estradiol(E2) was significantly higher than that before treatment.Ovarian enlargement and polycystic changes,menstrual cycle,menstrual flow and menstrual period were improved in varying degrees.[Conclusions] Jiawei Buzhong Yiqi Decoction has a good clinical effect in the treatment of obese PCOS.
文摘目的:探讨女性多囊卵巢综合症(Polycystic Ovary Syndrome,PCOS)患者维生素D缺乏与胰岛素水平的相关性。方法:回顾性分析2014年3月至2017年3月的在我院住院并诊断为PCOS的患者45人,选取45位健康人作为对照组。分别检测维生素D水平和心血管危险因素,如胰岛素、空腹血糖、血脂,以及性腺激素等。比较病例组及对照组维生素D水平及心血管危险因素的差异,并进行相关性分析。结果:通过T检验和Pearson相关分析发现病例组较对照组维生素D的水平更低,胰岛素水平偏高(P <0.05)。相关性分析表明PCOS患者中维生素D缺乏与胰岛素及胰岛素抵抗指数HOMA-IR(Homeostatic Model of Assessment-Insulin Resistance Index)相关(r=-0.172,P <0.05)。结论:PCOS患者更容易出现维生素D缺乏,这可能与PCOS患者内分泌代谢紊乱所致胰岛素抵抗相关。