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Co-morbidity of cervical incompetence with polycystic ovarian syndrome (PCOS) negatively impacts prognosis: A retrospective analysis of 178 patients.

Abstract

BACKGROUND

Cervical incompetence is an important cause of miscarriage and premature birth and polycystic ovary syndrome is a heterogeneous endocrine disorder that is the most common cause of anovulatory infertility and eugonadotrophic hypogonadism. By now, it is still debated whether women with PCOS have an increased risk of miscarriage and there have been no studies about the pregnancy outcomes of cervical incompetence patients with PCOS.

METHODS

The following clinical data of cervical incompetence patients with/without PCOS who were treated between September 2006 and September 2013 were retrospectively analysed: onset gestational age, termination gestational age, pregnancy outcome, co-morbid insulin resistance (IR) in PCOS patients, the influence of IR, co-morbid hyperandrogenism (HA) in PCOS patients, and the influence of HA. The independent samples t-test and chi-square trend test were used to analyse the data.

RESULTS

A total of 178 singleton pregnancy cases with cervical incompetence were identified. The average onset gestational age was 23.9 ± 4.3 weeks, and the average termination gestational age was 32.5 ± 5.5 weeks. Of these 178 singleton pregnancy cases, 40 (22.5 %) ended in miscarriage, 82 (46.1 %) ended in preterm birth, and 56 (31.5 %) ended in term birth. Eighty cases (44.9 %) exhibited PCOS co-morbidity, and those cases had an average onset gestational age of 22.3 ± 3.8 weeks and an average termination gestational age of 31.2 ± 5.7 weeks, which were both significantly different from those of the non-PCOS group (both P < 0.001). Compared with the non-PCOS group (15.3 % miscarriage, 48.0 % preterm birth, and 36.7 % term birth), the PCOS group exhibited worse pregnancy outcomes (31.3 % miscarriage, 43.8 % preterm birth, and 25 % term birth) (P = 0.01). Among the 80 PCOS patients, 45 (56.3 %) exhibited co-morbid IR, and the IR group exhibited significantly worse pregnancy outcomes than the non-IR group (P = 0.03). Among the 80 PCOS patients, 54 cases (67.5 %) exhibited co-morbid HA, and there was no statistical difference on the pregnancy outcomes between the two groups. The multivariate logistic regression model revealed that PCOS was significantly correlated with miscarriage (OR: 3.72, 95 % CI: 1.37-10.13).

CONCLUSIONS

The cervical incompetence patients with co-morbid PCOS exhibited earlier onset gestational ages, earlier termination gestational ages and worse pregnancy outcomes. For patients with co-morbid insulin resistance, the pregnancy outcomes were worse than expected.

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  • Authors+Show Affiliations

    ,

    Obstetrics & Gynecology Department, Peking University Third Hospital, Beijing, 100191, China.

    ,

    Obstetrics & Gynecology Department, Peking University Third Hospital, Beijing, 100191, China.

    ,

    Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, 100191, China.

    Obstetrics & Gynecology Department, Peking University Third Hospital, Beijing, 100191, China. yangaogi@163.com.

    Source

    BMC pregnancy and childbirth 16:1 2016 10 12 pg 308

    MeSH

    Abortion, Spontaneous
    Adult
    Chi-Square Distribution
    Comorbidity
    Female
    Gestational Age
    Humans
    Hyperandrogenism
    Insulin Resistance
    Logistic Models
    Multivariate Analysis
    Polycystic Ovary Syndrome
    Pregnancy
    Pregnancy Outcome
    Premature Birth
    Prognosis
    Retrospective Studies
    Uterine Cervical Incompetence

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    27733131

    Citation

    Wang, Yongqing, et al. "Co-morbidity of Cervical Incompetence With Polycystic Ovarian Syndrome (PCOS) Negatively Impacts Prognosis: a Retrospective Analysis of 178 Patients." BMC Pregnancy and Childbirth, vol. 16, no. 1, 2016, p. 308.
    Wang Y, Gu X, Tao L, et al. Co-morbidity of cervical incompetence with polycystic ovarian syndrome (PCOS) negatively impacts prognosis: A retrospective analysis of 178 patients. BMC Pregnancy Childbirth. 2016;16(1):308.
    Wang, Y., Gu, X., Tao, L., & Zhao, Y. (2016). Co-morbidity of cervical incompetence with polycystic ovarian syndrome (PCOS) negatively impacts prognosis: A retrospective analysis of 178 patients. BMC Pregnancy and Childbirth, 16(1), p. 308.
    Wang Y, et al. Co-morbidity of Cervical Incompetence With Polycystic Ovarian Syndrome (PCOS) Negatively Impacts Prognosis: a Retrospective Analysis of 178 Patients. BMC Pregnancy Childbirth. 2016 10 12;16(1):308. PubMed PMID: 27733131.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Co-morbidity of cervical incompetence with polycystic ovarian syndrome (PCOS) negatively impacts prognosis: A retrospective analysis of 178 patients. AU - Wang,Yongqing, AU - Gu,Xunke, AU - Tao,Liyuan, AU - Zhao,Yangyu, Y1 - 2016/10/12/ PY - 2015/10/13/received PY - 2016/10/04/accepted PY - 2016/10/14/entrez PY - 2016/10/14/pubmed PY - 2017/11/29/medline KW - Cervical incompetence KW - Hyperandrogenism KW - Insulin resistance KW - Polycystic ovary syndrome KW - Preterm birth SP - 308 EP - 308 JF - BMC pregnancy and childbirth JO - BMC Pregnancy Childbirth VL - 16 IS - 1 N2 - BACKGROUND: Cervical incompetence is an important cause of miscarriage and premature birth and polycystic ovary syndrome is a heterogeneous endocrine disorder that is the most common cause of anovulatory infertility and eugonadotrophic hypogonadism. By now, it is still debated whether women with PCOS have an increased risk of miscarriage and there have been no studies about the pregnancy outcomes of cervical incompetence patients with PCOS. METHODS: The following clinical data of cervical incompetence patients with/without PCOS who were treated between September 2006 and September 2013 were retrospectively analysed: onset gestational age, termination gestational age, pregnancy outcome, co-morbid insulin resistance (IR) in PCOS patients, the influence of IR, co-morbid hyperandrogenism (HA) in PCOS patients, and the influence of HA. The independent samples t-test and chi-square trend test were used to analyse the data. RESULTS: A total of 178 singleton pregnancy cases with cervical incompetence were identified. The average onset gestational age was 23.9 ± 4.3 weeks, and the average termination gestational age was 32.5 ± 5.5 weeks. Of these 178 singleton pregnancy cases, 40 (22.5 %) ended in miscarriage, 82 (46.1 %) ended in preterm birth, and 56 (31.5 %) ended in term birth. Eighty cases (44.9 %) exhibited PCOS co-morbidity, and those cases had an average onset gestational age of 22.3 ± 3.8 weeks and an average termination gestational age of 31.2 ± 5.7 weeks, which were both significantly different from those of the non-PCOS group (both P < 0.001). Compared with the non-PCOS group (15.3 % miscarriage, 48.0 % preterm birth, and 36.7 % term birth), the PCOS group exhibited worse pregnancy outcomes (31.3 % miscarriage, 43.8 % preterm birth, and 25 % term birth) (P = 0.01). Among the 80 PCOS patients, 45 (56.3 %) exhibited co-morbid IR, and the IR group exhibited significantly worse pregnancy outcomes than the non-IR group (P = 0.03). Among the 80 PCOS patients, 54 cases (67.5 %) exhibited co-morbid HA, and there was no statistical difference on the pregnancy outcomes between the two groups. The multivariate logistic regression model revealed that PCOS was significantly correlated with miscarriage (OR: 3.72, 95 % CI: 1.37-10.13). CONCLUSIONS: The cervical incompetence patients with co-morbid PCOS exhibited earlier onset gestational ages, earlier termination gestational ages and worse pregnancy outcomes. For patients with co-morbid insulin resistance, the pregnancy outcomes were worse than expected. SN - 1471-2393 UR - https://www.unboundmedicine.com/medline/citation/27733131/Co_morbidity_of_cervical_incompetence_with_polycystic_ovarian_syndrome__PCOS__negatively_impacts_prognosis:_A_retrospective_analysis_of_178_patients_ L2 - https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-016-1094-6 DB - PRIME DP - Unbound Medicine ER -