Effects of cervical insufficiency combined with insulin resistance on pregnancy prognosis
10.3760/cma.j.cn101441-20190212-00046
- VernacularTitle:宫颈机能不全合并胰岛素抵抗对妊娠结局的影响
- Author:
Lei WANG
1
;
Min REN
1
;
Xiangli HONG
1
;
Huimin KONG
1
Author Information
1. 同济大学附属第一妇婴保健院超声科，上海 200040
- Publication Type:Journal Article
- Keywords:
Cervical incompetence;
Insulin resistance;
Preterm birth;
Polycystic ovary syndrome
- From:
Chinese Journal of Reproduction and Contraception
2020;40(3):225-229
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the incidence of insulin resistance (IR) in patients with cervical insufficiency and the risk factors of cervical incompetence.Methods:The clinical data of patients from Reproductive Immunology Department (former Recurrent Spontaneous Abortion Clinic) and the department of cervical miscarriage and preterm delivery with cervical insufficiency in Shanghai First Maternal and Infant Hospital, Tongji University School of Medicine from September 2015 to September 2018 were retrospectively analyzed. The general conditions of the patients were compared, and the pregnancy outcomes of patients with IR were observed.Results:A total of 212 single pregnancy patients with cervical insufficiency were collected, the onset gestational age was (22.0±3.21) weeks, the termination gestational age was (32.62±4.36) weeks. Among them, 41 cases (19.3%) were ended in miscarriage, 104 cases (49.1%) were ended in preterm birth, and 67 cases (31.6%) were ended in term birth. In 92 patients (43.4%) with IR, the onset gestational age was (20.7±2.4) weeks and the termination gestational age was (30.5±4.2) weeks, which were significantly different from non-IR group [the onset gestational age was (23.8±3.3) weeks and the termination gestational age was (34.9±3.6) weeks ( P<0.001， P<0.001)]. Compared with 120 cases in non-IR group (7.5% abortion, 50.8% preterm birth, 41.7% preterm birth), the pregnancy outcome in IR group was worse (34.8% abortion, 47.7% preterm birth, 18.5% preterm birth) ( P=0.001， P=0.269， P=0.001). Multivariate logistic regression model showed that IR was significantly correlated with abortion ( OR=3.240, 95% CI=2.569-4.089， P=0.001). In addition, body mass index (BMI) and polycystic ovary syndrome (PCOS) were also risk factors for miscarriage in patients with cervical insufficiency ( OR=1.108， 95% CI=1.11-1.22， P=0.001； OR=1.507， 95% CI=1.191-1.906， P=0.001). Conclusion:Patients with cervical incompetence combined with IR had earlier onset gestational ages, earlier termination gestational ages and the risk of miscarriage is increased.
