Pregnancy Outcomes in Polycystic Ovary Syndrome

多囊卵巢综合症的妊娠结局

• 批准号: 7650015
• 负责人: Joan C Lo
• 金额: $ 53.14万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-06-01 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7650015
• 关键词: Admission activity; Adverse effects; Affect; Age; Androgens; Anovulation; Body mass index; California; Chronic; Clinical; Data; Data Sources; Diagnosis; Disease; Doctor of Medicine; Eclampsia; Endocrine System Diseases; Epidemiology; Fertility; General Population; Gestational Diabetes; Hypertension induced by pregnancy; Impact evaluation; Incidence; Insulin Resistance; Integrated Delivery of Health Care; Investigation; Mediating; Metabolic; Metabolic syndrome; Neonatal; Neonatal Intensive Care Units; Neonatal Mortality; Outcome; Perinatal; Polycystic Ovary Syndrome; Population; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Pregnant Women; Premature Birth; Registries; Reproductive History; Research Personnel; Risk; Small for Gestational Age Infant; Stratification; System; United States; Weight Gain; Woman; aged; design; electronic data; improved; insight; population based; pregnant; programs; reproductive; therapeutic development

DESCRIPTION (provided by applicant): Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among reproductive-age women, affecting ~5-10 percent of women in the general population. Clinical features of PCOS include chronic anovulation, androgen excess, and polycystic ovaries, with insulin resistance considered a central factor. In women with PCOS who do get pregnant, limited data suggest there may be a higher incidence of pregnancy complications, including gestational diabetes and hypertensive disorders. However, these investigations have been conducted in only selected groups and there have been no large population-based studies of pregnancy outcomes among women with PCOS, and extremely limited data on relevant neonatal outcomes. The membership of Kaiser Permanente Northern California, one of the largest integrated health care delivery systems in the US, presents a unique opportunity to investigate the epidemiology and pregnancy-related outcomes of women with diagnosed PCOS within a large multiethnic population. Using the Kaiser Permanente PCOS Registry, which includes -13,000 women with diagnosed PCOS, in addition to automated electronic data sources and targeted chart review, we propose to evaluate whether specific gestational and neonatal adverse outcomes are associated with PCOS, and potential mediating factors. The three Specific Aims of our study are the following: AIM 1. To evaluate the effects of PCOS status on the incidence of gestational diabetes, gestational hypertension, and pre-ecclampsia/ecclampsia among pregnant women. AIM 2. Among the subset of women with PCOS who become pregnant, to identify clinical, metabolic and reproductive factors which predict an increased risk of gestational diabetes and pre-ecclampsia/ecclampsia. AIM 3. To evaluate the association of maternal PCOS status with the incidence of adverse neonatal outcomes, including macrosomia, premature delivery and neonatal intensive care unit (NICU) admission. Secondarily, we will evaluate the association of PCOS status with the incidence of small-for-gestational-age infants and overall neonatal mortality. The proposed study will provide a rigorous evaluation of the impact of PCOS on pregnancy-related and neonatal outcomes and hopefully yield insights into better risk stratification and development of therapeutic strategies designed to improve perinatal outcomes among the growing population of women with PCOS.

描述（由申请人提供）：多囊卵巢综合症 (PCOS) 是育龄女性中最常见的内分泌疾病之一，影响总人口中约 5-10% 的女性。 PCOS 的临床特征包括慢性无排卵、雄激素过多和多囊卵巢，其中胰岛素抵抗被认为是核心因素。对于怀孕的多囊卵巢综合症女性，有限的数据表明妊娠并发症的发生率可能更高，包括妊娠期糖尿病和高血压。然而，这些调查仅在选定的群体中进行，并且没有针对多囊卵巢综合症女性妊娠结局进行大规模的人群研究，有关新生儿结局的数据也极其有限。北加州 Kaiser Permanente 是美国最大的综合医疗保健服务系统之一，其成员身份提供了一个独特的机会，可以在大量多种族人口中调查被诊断为 PCOS 的女性的流行病学和妊娠相关结果。使用 Kaiser Permanente PCOS 登记系统（其中包括 -13,000 名被诊断为 PCOS 的女性），除了自动电子数据源和有针对性的图表审查之外，我们建议评估特定的妊娠和新生儿不良结局是否与 PCOS 相关，以及潜在的中介因素。我们研究的三个具体目标如下： 目标 1. 评估 PCOS 状态对孕妇妊娠期糖尿病、妊娠期高血压和先兆子痫/子痫发生率的影响。目标 2. 在怀孕的 PCOS 女性亚群中，确定预测妊娠期糖尿病和先兆子痫/子痫风险增加的临床、代谢和生殖因素。目的 3. 评估孕产妇 PCOS 状况与不良新生儿结局发生率的关系，包括巨大儿、早产和新生儿重症监护病房 (NICU) 入住。其次，我们将评估 PCOS 状况与小于胎龄儿发生率和新生儿总体死亡率的关系。拟议的研究将对 PCOS 对妊娠相关和新生儿结局的影响进行严格评估，并希望深入了解更好的风险分层和治疗策略的制定，旨在改善不断增长的 PCOS 女性群体的围产期结局。

项目成果

Risk of preterm delivery in non-diabetic women with polycystic ovarian syndrome.

• DOI: 10.1038/jp.2011.194
• 发表时间: 2012-10
• 期刊: JOURNAL OF PERINATOLOGY
• 影响因子: 2.9
• 作者: Yamamoto, M.;Feigenbaum, S. L.;Crites, Y.;Escobar, G. J.;Yang, J.;Ferrara, A.;Lo, J. C.
• 通讯作者: Lo, J. C.