中国多囊卵巢综合征患者妊娠并发症发生率的Meta分析

发布时间：2019-03-26 20:34

【摘要】：目的:采用Meta分析的方法评价我国多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者妊娠并发症的发生现状。方法:系统检索Pub Med,Web of Science,Embase,Medline,Cochrane协作网,中国知网,重庆维普及中国生物医学文献数据库等从建库至2017年4月1日前公开发表的、报道中国PCOS患者妊娠并发症发生率的文献。采用随机效应模型估计合并率及95%可信区间。以纽卡斯尔-渥太华量表(Newcastle-Ottawa Scale,NOS)为标准对最终纳入的文献进行质量评价。采用亚组分析评价孕前超重/肥胖及胰岛素抵抗对PCOS孕妇妊娠并发症发生率的影响。结果:最终纳入文献59篇,合计PCOS孕妇13 378例,非PCOS孕妇49 395例。PCOS孕妇中各种妊娠并发症的发生率分别为:妊娠糖尿病20.26%、妊娠高血压13.94%、剖宫产64.16%、早产13.35%、巨大儿9.84%、低出生体重儿5.88%、小于胎龄儿5.25%、大于胎龄儿8.45%、新生儿畸形1.93%、围产儿死亡0.88%、新生儿窒息3.71%,且PCOS孕妇中妊娠糖尿病、妊娠高血压、剖宫产、早产、巨大儿及新生儿窒息的发生率明显高于非PCOS孕妇(P0.05)。亚组分析结果显示:超重/肥胖的PCOS孕妇中妊娠糖尿病、巨大儿及大于胎龄儿的发生率明显高于BMI正常的PCOS孕妇(均P0.05);孕前合并胰岛素抵抗的PCOS孕妇中妊娠糖尿病、早产、巨大儿的发生率明显高于未合并胰岛素抵抗的PCOS孕妇(均P0.05)。结论:PCOS可导致孕妇妊娠并发症的发生风险增加,是妊娠并发症发生的一个重要危险因素。
[Abstract]:Objective: to evaluate the status of pregnancy complications in patients with polycystic ovary syndrome (polycystic ovary syndrome,PCOS) by Meta analysis. Methods: a systematic search of Pub Med,Web of Science,Embase,Medline,Cochrane collaboration Network, China knowledge Network, Chongqing Uygur popular Chinese Biomedical Literature Database, etc., was published from the establishment of the database to April 1, 2017. This paper reports the incidence of pregnancy complications in Chinese patients with PCOS. The combination rate and 95% confidence interval are estimated by the stochastic effect model. Newcastle-Ottawa scale (Newcastle-Ottawa Scale,NOS) was used to evaluate the quality of the literature. The effects of prepregnancy overweight / obesity and insulin resistance on the incidence of pregnancy complications in PCOS pregnant women were assessed by subgroup analysis. Results: 59 literatures were included, totaling 13,378 PCOS pregnant women and 49,395 non-PCOS pregnant women. The incidences of pregnancy complications were 20.26% in gestational diabetes mellitus, 13.94% in pregnancy hypertension, 64.16% in cesarean section, and 20.26% in pregnant women with gestational diabetes mellitus, 13.94% in pregnancy hypertension and 64.16% in cesarean section, respectively. Premature birth 13.35%, macrosomia 9.84%, low birth weight 5.88%, smaller than gestational age 5.25%, greater than gestational age 8.45%, neonatal malformation 1.93%, perinatal death 0.88%, neonatal asphyxia 3.71%. The incidence of gestational diabetes mellitus, pregnancy hypertension, cesarean section, premature delivery, macrosomia and neonatal asphyxia in PCOS pregnant women was significantly higher than that in non-PCOS pregnant women (P0.05). The results of subgroup analysis showed that the incidence of gestational diabetes mellitus, macrosomia and gestational age in overweight / obese PCOS pregnant women was significantly higher than that in PCOS pregnant women with normal BMI (P0.05). The incidence of gestational diabetes, preterm delivery and macrosomia in PCOS pregnant women with insulin resistance before pregnancy was significantly higher than that in PCOS pregnant women without insulin resistance (P0.05). Conclusion: PCOS can increase the risk of pregnancy complications, which is an important risk factor of pregnancy complications.
【作者单位】：中南大学湘雅公共卫生学院流行病与卫生统计学系;四川省德阳市疾病预防控制中心信息所;
【分类号】：R711.75;R714.2

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