A Research About The Adverse Pregnancy Outcomes And Influencing Factors In Women With Polycystic Ovary Syndrome

[Objectives] To investigate the pregnancy outcomes in women with polycystic ovary syndrome(PCOS),and study predictive value for the corresponding pathological situation factors to improve the quality of newborn babies and the pregnancy outcome.[Methods] 1.A total of 215 single pregnanant patients with PCOS were selected as Group PCOS,in which 68 patients with obstetric or neonatal complications were as Group PCOS-A and the other 147 patients with no complication were as Group PCOS-B.Besides,a total of 224 healthy pregnant women were randomly selected as Group Control.2.The general indexs(including age,height,blood pressure,weight,weight index(BMI),waist circumference,hipline,waist-to-hip ratio before pregnancy,parity,the increase weight at the 24 th week during pregnancy,and family history of high blood pressure and diabetes,et al)of women in Group PCOS were compared with that of Group Control.3.Hormone indexes(including FSH,LH,E2,T,PRL,SHBG,AMH,GLU,INS,FAI,et al)were defected and compared between Group PCOS and Group Control on the 2nd to 4th day in the menstrual cycle.4.All the women were treated with regularly prenataled check,and the pregnancy outcomes were observed.And the IGF-1,IL-18,and D-D dimer were recorded in late pregnancy.[Results] 1.Compared with Group Control,patients with PCOS bore significantly higher weight,BMI,waist circumference,hipline,waist-to-hip ratio before pregnancy and higher cesarean delivery rate,and earlier delivery pregnancy weeks(P?0.05).Sgnificant differences can be observed about the rate of treatened abortion,preterm birth,cesarean delivery,natural labour among 3 groups(P?0.05),and there was no intrauterine death in each group and no significant difference about aura preterm birth.Besides,the rate of aura preterm birth,preterm birth,and cesarean delivery in Group PCOS-A was higher than that in Group PCOS-B and Group Control(P?0.05),the highest natural labour rate was Group PCOS-A and the lowest was Group Control(P?0.05)?2.The indicences of gestational hypertension disease,gestational diabetes,an excess and little of amniotic fluid,the fetal distress in Group PCOS were significantly higher than that in Group Control(P> 0.05),while there was no difference about the indicence of premature rupture of membranes,fetal growth restriction,serious malformation of fetus,and postpartum hemorrhage between the 2 groups(P> 0.05).Besides,no significant difference could be observed about the neonatal birth weight,low quality of newborn,macrosomia,birth defects,neonatal asphyxia,the incidence of neonatal hypoglycemia between Group PCOS and Group Control.3.LH?T?SHBG?INS?PRL?FAI?HOMA-IR of Group PCOS were statistically different from that of Group Control(P <0.05).The IGF-1,D-D dimer and IL-18 in mother blood and umbilical cord blood in Group PCOS –A were statistically more than the other 2 groups(P<0.05),but there was no difference between Group PCOS –B and Group Control.The IGF-1 in mother blood and umbilical cord blood in PCOS patients were significantly higher than that of control group in gestational hypertension,gestational diabetes,preterm birth in pregnant women,while there were no significant difference about D-D dimer,IGF-1 and IL-18 level in each complication(P?0.05).4.Adverse pregnancy or neonatal outcomes as the dependent variable,we used the single factor Logistic regression analysis to study the relationship among the the general index,hormone indexes,and the IGF-1,IL-18,D-D dimer and adverse pregnancy or neonatal outcomes.The results showed that SHBG was the protective factors of adverse pregnancy or neonatal outcomes,while INS,FAI were the risk factors.[Conclusions] 1.Patients with PCOS have more adverse pregnant and neonatal outcomes,include mainly preterm birth,Gestational hypertension,gestational diabetes,abnormal amniotic fluid,the fetal distress.2.Inflammation may be involved in the occurrence of adverse pregnancy outcomes in PCOS process,characterized by an increase of the IL-18,IGF 1 in PCOS patients.3.High blood coagulation state is closely associated with PCOS adverse pregnancy outcomes.4.PCOS patients with abnormal endocrine metabolic state before childbirth(mainly with hyperandrogenism and high insulin levels),fast weight gain during pregnancy and so on are important factors of adverse obstetric outcome in patients with PCOS.SHBG is a protective factor for adverse pregnancy outcomes,while INS,FAI are risk factors.We should actively correct the undesirable state to improve mother-infant prognosis of patients with PCOS.