网络首发:2011-07-20,
纸质出版:2011
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多囊卵巢综合征及不同受孕方式对妊娠结局的影响[J]. 中山大学学报(医学科学版), 2011,32(4).
Influence of Polycystic Ovary Syndrome and Different Ways to Conceive on Pregnancy Outcomes[J]. Journal of Sun Yat-sen University (Medical Sciences), 2011, 32(4).
【目的】 探讨多囊卵巢综合征(PCOS)患者与普通孕妇妊娠结局的差别及不同受孕方式与妊娠结局的关系【方法】 选择2007年1月至2010年12月在中山大学孙逸仙纪念医院妇产科确诊为PCOS并通过不同方式受孕的220例孕妇为PCOS组
同时期在本院就诊有妊娠结局(包括自然流产人工流产活产及死胎畸形引产)无PCOS史的普通孕产妇11 778例为对照组
比较两组孕妇的妊娠并发症及妊娠结局同时对PCOS组中三种受孕方式(自然促排卵及体外受精胚胎移植受孕)的妊娠结局进行比较 【结果】 PCOS组与对照组妊娠并发症发生率分别为自然流产34.54% vs 8.86%
妊娠期糖代谢异常49.31% vs 8.22%
妊娠期高血压疾病10.42% vs 2.17%
早产18.75% vs 10.13%
双胎22.92% vs 4.26%
胎儿生长受限7.64% vs 2.11%新生儿黄疸17.36% vs 8.95%
PCOS孕妇高于普通孕妇
差异有统计学意义(P < 0.05)两组巨大胎儿胎儿畸形及新生儿窒息的发生率分别为4.17% vs 2.46%
2.08% vs 2.52%
10.42% vs 7.84%
无明显差异PCOS患者体外受精胚胎移植(IVF-ET)组及促排卵组与自然受孕组相比
双胎发生率分别为45.24% vs 2.90%
36.36% vs 2.90%;胎儿生长受限发生率分别为11.90% % vs 1.45%
15.15%% vs 1.45%
IVF-ET组及促排卵组大于自然受孕组
差别有统计学意义;IVF-ET组促排卵组自然受孕组早产发生率分别为26.19%27.27%10.14%
三组相比差别有统计学意义
但两两比较时任意两组相比差别均无统计学意义;其余妊娠并发症在3种不同方式受孕组无显著差别【结论】 PCOS患者妊娠后自然流产妊娠期糖代谢异常妊娠期高血压疾病早产双胎胎儿生长受限及新生儿黄疸的发病率显著升高
两组巨大胎儿畸形及窒息的发生率无明显差异除双胎胎儿生长受限及早产外不同受孕方式对妊娠并发症及妊娠结局无明显影响
【Objective】 To investigate the pregnant outcomes of women with polycystic ovary syndrome (PCOS) and the effects of different conceived ways on it. 【Methods】 A total of 220 pregnant women with PCOS in Sun Yat-sen Memorial Hospital (SYSM) of Sun Yat-sen University between January 2007 and December 2010 were collected
11778 pregnant women without PCOS at the same period as the control. The pregnant complication
pregnant outcome
as well as the various conceived ways including natural conception
ovulation and in vitro fertilization-embryo transfer (IVF-ET) were compared. 【Results】 The incidences of spontaneous abortion
abnormal glucose metabolism
hypertensive disorders in pregnancy
premature delivery
twins
fetal growth restriction (FGR) and neonatal jaundice were higher in PCOS group than that in control group (P < 0.05)
which were 34.54% vs 8.86%
49.31% vs 8.22%
10.42% vs 2.17%
18.75% vs 10.13%
22.92% vs 4.26%
7.64% vs 2.11% and 17.36% vs 8.95%
respectively. Besides
the incidence of macrosomia (4.17% vs 2.46%)
fetal malformation (2.08% vs 2.52%)
and neonatal asphyxia (10.42% vs 7.84%) in PCOS group were also increased
compared to the control group
although there were no statistically significance. In terms of the effects of conceived ways on pregnant outcomes
compared to the PCOS patients in natural conception
the incidence of having twins (45.24% vs 2.90%) and FGR (11.90% % vs 1.45%) of PCOS patients conceived by IVF-ET increased; those in patients taking ovulation showed the same trend
whose incidences of twins and FGR were 36.36% and 15.15%
respectively. The preterm birth rate of IVF- ET
ovulation group and natural conception group were 26.19%
27.27%
and 10.14%
respectively. The difference was statistically significant among these three groups. No significant differences were showed on the incidences of the other complications. 【Conclusions】 Incidences of pregnant outcomes including spontaneous abortion
abnormal glucose metabolism
hypertensive disorders in pregnancy
preterm labor
twins
fetal growth restriction and neonatal jaundice
but not macrosomia
fetal malformation and asphyxia
significantly increased among women with PCOS. The conceived ways of PCOS patients play a role on the incidence of twins
FGR
and preterm delivery.
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