摘要
目的比较肥胖及非肥胖型多囊卵巢综合征患者冷冻胚胎移植后妊娠期风险及结局。方法纳入2015年1月至2017年12月在桂林医学院附属医院生殖中心行体外受精-胚胎移植助孕并行冻融胚胎移植的多囊卵巢综合征患者265例,根据体重指数分为肥胖组(体重指数≥25 kg/m^2)患者80例,非肥胖组(体重指数<25 kg/m^2)患者185例。结果1.肥胖组多囊卵巢综合征患者基础E2水平明显高于非肥胖组[(59.72±14.36)pg/mL vs(35.41±9.28)pg/mL,P<0.05],ET日内膜厚度、ET胚胎数目、生化妊娠率、异位妊娠率和流产率两组均无明显差异(P>0.05)。2.非肥胖组临床妊娠率(36.22%vs 23.75%)和活产率(35.14%vs 22.50%)均高于肥胖组(P<0.05)。3.妊娠期高血压、早产、胎膜早破及胎盘早剥发生率两组均无明显差异(P>0.05)。4.肥胖组多囊卵巢综合征患者与非肥胖型PCOS患者相比孕期体重增加[(17.98±3.15)kg vs(12.46±2.36)kg],妊娠合并糖尿病(33.33%vs 6.15%),剖宫产率(55.56%vs 26.15%)均高于非肥胖组,差异有统计学意义(P<0.05)。5.肥胖组新生儿出生体重明显高于非肥胖组[(3884±415)g vs(3027±436)g,P<0.05];而胎龄、身长、性别比、新生儿畸形等两组均无明显差异(P>0.05)。结论肥胖型多囊卵巢综合征患者冷冻胚胎移植临床妊娠率、活产率均降低,妊娠期糖尿病发病率增加,剖宫产率增加,新生儿体重也增加,临床上应重视肥胖多囊卵巢综合征患者管理,以降低妊娠期合并症和改善产科、新生儿结局。
Objective To compare the gestational complications and prenatal outcomes in obese and non-obese polycystic ovary syndrome(PCOS)patients after frozen embryo transfer.Methods A total of 265 PCOS patients who underwent IVF-ET treatment and subsequently FETs in the Affiliated Hospital of Guilin Medical College reproductive center from January 2015 to December 2017 were enrolled.According to the body mass index,80 patients were divided into obese group(body mass index≥25 kg/m^2).The other 185 patients were classified in non-obese group(body mass index<25 kg/m^2).Results 1.The basal E2 level of PCOS patients in obese group was significantly higher than that in non-obese group[(59.72±14.36)pg/mL vs(35.41±9.28)pg/mL,P<0.05].There was no significant difference between ET day endometrial thickness,ET embryo number,biochemical pregnancy rate,ectopic pregnancy rate and abortion rate(P>0.05).2.The clinical pregnancy rate and live birth rate were higher in the non-obese group than that in the obese group(36.22%vs 23.75%,35.14%vs 22.50%,P<0.05).3.There was no significant difference in the incidence of hypertension,premature delivery,premature rupture of membranes and placental abruption in pregnancy.(P>0.05).4.Obese PCOS patients gained weight during pregnancy,Gestational diabetes were higher than non-obese group,the difference was statistically significant[(17.98±3.15)kg vs(12.46±2.36)kg,33.33%vs 6.15%,P<0.05];cesarean section rate was also significantly higher than non-obesity Group(55.56%vs 26.15%,P<0.05).The birth weight of the obese group was significantly higher than that of the non-obese group(P<0.05).5.The neonatal birth weight of obese group was significantly higher than that of the non-obese group[(3884±415)g vs(3027±436)g,P<0.05],there was no significant difference in the gestational age,body length,sex ratio,neonatal malformation(P>0.05).Conclusions The clinical pregnancy rate and live birth rate of obese PCOS patients decreased,the incidence of gestational diabetes increased,the cesarean section rate increa
作者
田正平
张方华
姚军
陈正勤
以善佳
何丽霞
TIAN Zheng-ping;ZHANG Fang-hua;YAO Jun;CHEN Zheng-qin;YI Shan-jia;He Li-xia(Reproductive Center,the Affiliated Hospital of Guilin Medical College,Guilin541001,China)
出处
《妇产与遗传（电子版）》
2019年第3期14-18,共5页
Obstetrics-Gynecology and Genetics (Electronic Edition)
基金
广西卫生和计划生育委员会自筹经费科研课题(Z20170839)。
关键词
冷冻胚胎移植
多囊卵巢综合征
肥胖
妊娠期合并症
产科结局
Frozen embryo transplantation
Polycystic ovary syndrome
Obesity
Gestational complications
Obstetric outcome
