孕前合并有超重／肥胖与多囊卵巢综合征的孕妇妊娠结局分析

摘要

Objective It is to study and analysis the pregnancy outcome of women who were diagnosed as overweight/obe-sity and polycystic ovary syndrome ( PCOS) before the pregnancy.Methods The date of 267 cases of pregnant women met the selected standard were retrospectively analyzed.All the cases were divided into four groups in accordance with the pre-preg-nancy body mass index ( BMI) and whether with PCOS or not, 60 cases with overweight/obese and PCOS before pregnancy were assigned to group A,65 cases with PCOS and normal weight before pregnancy were assigned to group B, 62 cases with o-verweight or obesity and without PCOS before pregnancy were assigned to group C, 80 cases with normal body weight and with-out PCOS before pregnancy were assigned to group D, and then the pregnancy outcome among these groups were analyzed and compared.Results The rates of threatened abortion, spontaneous abortion, premature birth and cesarean delivery in group A were higher than that in group C and D,but the rate of vaginal delivery was the lowest in group A.The rate of gestational hyper-tension disease in group A was higher than that in group B and D,the rate of gestational diabetes in group A was the highest. There was no significant difference in the incidence of hydramnios, oligohydramnios, premature rupture of membranes, post-partum hemorrhage among the four groups (P>0.05);in addition, incidence of giant fetus, birth defects and low birth weight newborn asphyxia, neonatal hypoglycemia among the four groups were not significantly different (P>0.05).Conclusion O-verweight/obesity and PCOS before the pregnancy may increase the risk of threatened abortion, spontaneous abortion, prema-ture birth and cesarean delivery during the pregnancy, but it does not effect the incidence of polyhydramnios, oligohydramnios, premature rupture of membranes, postpartum hemorrhage and the incidence of neonatal complications.%目的：探讨分析孕前超重／肥胖与多囊卵巢综合征（ PCOS ）对妊娠结局的影响。方法回顾性分析住院分娩的符合入选标准的267例孕妇资料，按照孕前体质量指数与有无PCOS病史分为4组，其中孕前超重／肥胖PCOS孕妇60例为超重合并PCOS组，孕前体质量指数正常合并PCOS孕妇65例为PCOS组，孕前超重／肥胖无PCOS孕妇62例为超重组，孕前体质量指数正常且无PCOS孕妇80例为正常组，分析比较4组的妊娠结局。结果超重合并PCOS组先兆流产率、早期自然流产率、早产率和剖宫产率均显著高于超重组和正常组（P均＜0．05），顺产率显著低于其他组（P均＜0．05），与PCOS组比较差异无统计学意义（P均＞0．05）；PCOS组早期自然流产率明显高于正常组（P＜0．05），顺产率显著低于正常组（P＜0.05）。超重合并PCOS组妊娠期高血压疾病发生率显著高于PCOS组和正常组（P均＜0．05），PCOS组、超重组妊娠高血压疾病发生率均显著高于正常组（ P均＜0．05）；超重合并PCOS组妊娠期糖尿病发生率显著高于其他组（ P均＜0．05），PCOS组显著高于正常组（P＜0．05）。4组间羊水过多、羊水过少、胎膜早破、产后出血发生率及低体质量儿、巨大儿、新生儿畸形、新生儿窒息、新生儿低血糖发生率比较差异均无统计学意义（ P均＞0．05）。结论孕前合并有超重／肥胖与PCOS病史可能增加孕期发生先兆流产、早期自然流产、早产和剖宫产的风险，但对于羊水过多、羊水过少、胎膜早破、产后出血等并发症和新生儿并发症的发生率并无明显影响。