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Hum. Reprod..2020 Jul;deaa144. doi: 10.1093/humrep/deaa144.Epub 2020-07-09.


Associations between polycystic ovary syndrome and adverse obstetric and neonatal outcomes: a population study of 9.1 million births.

  • Ginevra Mills
  • Ahmad Badeghiesh
  • Eva Suarthana
  • Haitham Baghlaf
  • Michael H Dahan
PMID: 32644124 DOI: 10.1093/humrep/deaa144.



多嚢胞性卵巣症候群(PCOS)は、Healthcare Cost and Utilization Project-Nationwide Inpatient Sample(HCUP-NIS)データベースの分析に基づいて、分娩および新生児の転帰について独立したリスクをもたらすのか?

STUDY QUESTION: Does polycystic ovary syndrome (PCOS) confer an independent risk for adverse delivery and neonatal outcomes, based on analysis of the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS) database?



SUMMARY ANSWER: After controlling for all potential confounding effects, women with PCOS are at an increased risk of experiencing preterm pre-labour rupture of membranes (PPROM), pre-term delivery (PTD), placental abruption, caesarean section (C/S) delivery, chorioamnionitis and post-partum maternal infections.



WHAT IS KNOWN ALREADY: PCOS may be associated with an increased risk of adverse perinatal outcomes. However, there remain significant gaps in understanding the correlation between PCOS and important delivery and neonatal complications.


これは、2004 年から 2014 年までの 11 年間の HCUP-NIS のデータを利用したレトロスペクティブな集団ベースのコホート研究である。2004 年から 2014 年までの全分娩のコホートを作成した。このグループの中で、PCOSを有する女性の分娩はすべて研究グループ(n=14882)の一部として同定され、残りの分娩はPCOS以外の分娩として分類され、参照グループ(n=9081906)を構成した。

STUDY DESIGN, SIZE, DURATION: This is a retrospective population-based cohort study utilising data from the HCUP-NIS over 11 years from 2004 to 2014. A cohort of all deliveries between 2004 and 2014 inclusively was created. Within this group, all deliveries to women with PCOS were identified as part of the study group (n = 14 882), and the remaining deliveries were categorised as non-PCOS births and comprised the reference group (n = 9 081 906).



PARTICIPANTS/MATERIALS, SETTING, METHODS: The HCUP-NIS is the largest inpatient sample database in the USA and it is comprised of hospital inpatient stays throughout the entire country. It provides information relating to 7 million inpatient stays per year, includes ∼20% of admissions, and represents over 96% of the American population.


すべての潜在的交絡因子を調整した後、PCOSを有する女性はPPROM(aOR 1.48、95%CI 1.20-1.83)、PTD(aOR 1.37、95%CI 1.24-1.53)および胎盤剥離(aOR 1.63、95%CI 1.30-2.05)を経験する可能性が高く、C/S分娩(aOR 1.50、95%CI 1.40-1.61(すべてP<0.001))を経験する可能性が高かった。PCOSを持つ女性は、より頻繁に絨毛膜羊膜炎(aOR 1.58、95%CI 1.34-1.86、P<0.001)と母体感染症(aOR 1.58、95%CI 1.36-1.84(いずれもP<0.001))を発症した。多胎妊娠(aOR 1.27、95%CI 1.01~1.62、P=0.04)を除いて、PCOSの女性と参考群との間で、妊娠年齢の小さい(SGA)乳児を出産した女性の数(aOR 0.97、95%CI 0.82~1.15、P=0.72)に差はなかった。子宮内胎児死亡(IUFD)も両群間で同程度であった(aOR 1.03、95%CI 0.68-1.59、P=0.88)。しかし、先天性異常はPCOSを持つ女性の子供に発生する可能性が高かった(aOR 1.89、95%CI 1.51-2.38、P<0.001)。

MAIN RESULTS AND THE ROLE OF CHANCE: After adjustment for all potential confounders, women with PCOS were more likely to experience PPROM (aOR 1.48, 95% CI 1.20-1.83), PTD (aOR 1.37 95% CI 1.24-1.53) and placental abruption (aOR 1.63, 95% CI 1.30-2.05) and were more likely to deliver by C/S (aOR 1.50, 95% CI 1.40-1.61 (all P < 0.001). Women with PCOS more often developed chorioamnionitis (aOR 1.58, 95% CI 1.34-1.86, P < 0.001) and maternal infections (aOR 1.58, 95% CI 1.36-1.84 (both P < 0.001)). With the exception of multiple gestations (aOR 1.27, 95% CI 1.01-1.62, P = 0.04), there was no difference in the number of women who gave birth to small for gestational age (SGA) infants (aOR 0.97, 95% CI 0.82-1.15, P = 0.72) between the women with PCOS and the reference group. Intrauterine foetal deaths (IUFDs) were also comparable between the two groups (aOR 1.03, 95% CI 0.68-1.59, P = 0.88). However, congenital anomalies were more likely to occur in the offspring of women with PCOS (aOR 1.89, 95% CI 1.51-2.38, P < 0.001).



LIMITATIONS, REASONS FOR CAUTION: This is a retrospective analysis utilising an administrative database which relies on the accuracy and consistency of the individuals coding the data. There are known limitations in how accurately hospital coding is able to capture perinatal conditions and complications, making it difficult to know with certainty that such events are accurate.



WIDER IMPLICATIONS OF THE FINDINGS: Women with PCOS are more likely to experience adverse delivery and neonatal outcomes. It is important to additionally consider the risk of all other co-existing conditions frequently encountered in PCOS women, as these risks are additive and place women with PCOS at significantly increased risk of adverse pregnancy outcomes.



STUDY FUNDING/COMPETING INTEREST(S): No specific funding was obtained for this study. The authors have no conflicts of interest to disclose.

© The Author(s) 2020. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. All rights reserved. For permissions, please email: journals.permissions@oup.com.