应用倾向性评分匹配法评价体质量指数对多囊卵巢综合征围产结局的影响

    Application of propensity score matching to evaluate the influence of body mass index on the perinatal outcome of polycystic ovary syndrome

    • 摘要:
      目的通过倾向评分匹配法(PSM)排除混杂因素的干扰,探讨体质量指数(BMI)对多囊卵巢综合征(PCOS)围产结局的影响。
      方法回顾性分析进行系统产检并分娩的500例PCOS病人临床资料,根据产妇孕前BMI值分为正常BMI组(BMI 18.5~ < 24 kg/m2)264例、高BMI组(BMI≥24 kg/m2)236例,对2组基线资料进行比较。运用PSM方法平衡2组混杂因素,对PSM后的2组基线资料、围产结局进行比较。
      结果PSM匹配前,正常BMI组与高BMI组在年龄、PCOS家族史、孕史、早产史、流产史、孕前糖尿病、孕前高血压、PCOS病程、辅助生殖、孕期增重的比较差异有统计学意义(P < 0.05~P < 0.01)。PSM匹配后,2组一般资料差异均无统计学意义(P>0.05)。高BMI组在妊娠期糖尿病(GDM)、妊娠期高血压疾病(HDCP)、甲状腺功能异常及早产的发生率均高于正常BMI组(P < 0.05~P < 0.01);高BMI组与正常BMI组在剖宫产、羊水异常、胎膜早破、低体质量儿、巨大儿、新生儿窒息、新生儿低血糖比较差异无统计学意义(P>0.05)。
      结论高BMI对PCOS病人在GDM、HDCP、甲状腺功能异常及早产方面的影响较大。适当控制体质量,有助于改善母婴围产结局。

       

      Abstract:
      ObjectiveUsing propensity score matching (PSM) to eliminate the interference of confounding factors, to expbre the influence of body mass index (BMI) on the perinatal outcome of polycystic ovary syndrome (PCOS).
      MethodsThe clinical data of 500 PCOS patients who underwent a systematic obstetric check-up and gave birth were retrospectively analyzed.According to the pre-pregnancy BMI, the patients were divided into the normal BMI group (BMI 18.5- < 24 kg/m2) (n=264) and high BMI group (BMI ≥ 24 kg/m2) (n=236).The baseline data of the two groups were compared.The PSM was used to balance the confounding factors of the two groups, and the baseline data and perinatal outcomes after PSM were compared between the two groups.
      ResultsBefore the PSM matching, there were significant differences in age, family history of PCOS, history of pregnancy, history of preterm birth, history of miscarriage, pre-pregnancy diabetes, pre-pregnancy hypertension, PCOS course, assisted reproduction, and weight gain during pregnancy between the normal BMI group and the high BMI group (P < 0.05 to P < 0.01).After the PSM matching, there was no significant difference in general data between the two groups (P>0.05).The incidence of gestational diabetes mellitus (GDM), hypertension in pregnancy (HDCP), abnormal thyroid function and premature delivery in the high BMI group was significantly higher than that in the normal BMI group (P < 0.05 to P < 0.01).There were no significant differences in cesarean section, abnormal amniotic fluid, premature rupture of membranes, low birth weight, macrosomia, neonatal asphyxia, and neonatal hypoglycemia between the high BMI group and the normal BMI group (P>0.05).
      ConclusionsA high BMI has a significant impact on GDM, HDCP, abnormal thyroid function and premature delivery in PCOS patients.The proper weight control is helpful to improve the perinatal outcome of mothers and babies.

       

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