Higher pre‐pregnancy body mass index was associated with adverse pregnancy and perinatal outcomes in women with polycystic ovary syndrome after a freeze‐all strategy: A historical cohort study

Abstract Introduction Previous studies have demonstrated that abnormal body mass index (BMI) is associated with adverse pregnancy outcomes in frozen–thawed embryo transfer cycles. However, the relationship between BMI and pregnancy and perinatal outcomes in patients with polycystic ovary syndrome (P...

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Main Authors: Xinyao Hu, Enqi Yan, Wenju Peng, Yueping Zhou, Lei Jin, Kun Qian
Format: Article
Language:English
Published: Wiley 2024-05-01
Series:Acta Obstetricia et Gynecologica Scandinavica
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Online Access:https://doi.org/10.1111/aogs.14771
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author Xinyao Hu
Enqi Yan
Wenju Peng
Yueping Zhou
Lei Jin
Kun Qian
author_facet Xinyao Hu
Enqi Yan
Wenju Peng
Yueping Zhou
Lei Jin
Kun Qian
author_sort Xinyao Hu
collection DOAJ
description Abstract Introduction Previous studies have demonstrated that abnormal body mass index (BMI) is associated with adverse pregnancy outcomes in frozen–thawed embryo transfer cycles. However, the relationship between BMI and pregnancy and perinatal outcomes in patients with polycystic ovary syndrome (PCOS) remains unclear. Furthermore, whether a diagnosis of PCOS could result in adverse pregnancy and perinatal outcomes in women with different BMIs remains unknown. Material and methods A historical cohort study included 1667 women with PCOS and 12 256 women without PCOS after a freeze‐all policy between January 2016 and December 2020. The outcomes encompassed both pregnancy and perinatal outcomes. Multivariate logistic regression analysis and restricted cubic spline models were performed to eliminate confounding factors when investigating the relationship between BMI and different outcomes. Results After controlling for covariates, pregnancy outcomes were comparable between underweight women with PCOS and normal weight women with PCOS. However, overweight patients had a lower clinical pregnancy rate and an overall live birth rate. Furthermore, patients with obesity had a lower rate of multiple pregnancies but a higher rate of biochemical pregnancy than in the normal BMI group. Additionally, the restricted cubic spline models showed that as maternal BMI increased to 32 kg/m2, the clinical pregnancy rate and live birth rate after blastocyst transfer decreased, but the risks of preterm birth, gestational diabetes mellitus, macrosomia, large‐for‐gestational age (LGA) and very LGA increased in patients with PCOS after a freeze‐all strategy. Moreover, a diagnosis of PCOS resulted in a higher clinical pregnancy rate and live birth rate and a higher risk of small‐for‐gestational age in the normal weight group. However, women with PCOS in the overweight group exhibited higher risks of very preterm birth and gestational diabetes mellitus compared with women without PCOS. Conclusions This study showed that a higher BMI had a detrimental impact on the pregnancy and perinatal outcomes of PCOS patients undergoing a freeze‐all strategy. However, it was only statistically significant in the overweight group. A diagnosis of PCOS had a higher clinical pregnancy rate and live birth rate in normal weight women but higher risks of perinatal complications in normal weight and overweight women.
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spelling doaj-art-7a2e39cd63ee4482be454c7f1ba8fa562025-08-20T03:30:53ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122024-05-01103588489610.1111/aogs.14771Higher pre‐pregnancy body mass index was associated with adverse pregnancy and perinatal outcomes in women with polycystic ovary syndrome after a freeze‐all strategy: A historical cohort studyXinyao Hu0Enqi Yan1Wenju Peng2Yueping Zhou3Lei Jin4Kun Qian5Reproductive Medicine Center, Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaReproductive Medicine Center, Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaDepartment of Obstetrics and Gynecology, Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaReproductive Medicine Center, Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaReproductive Medicine Center, Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaReproductive Medicine Center, Tongji Hospital Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaAbstract Introduction Previous studies have demonstrated that abnormal body mass index (BMI) is associated with adverse pregnancy outcomes in frozen–thawed embryo transfer cycles. However, the relationship between BMI and pregnancy and perinatal outcomes in patients with polycystic ovary syndrome (PCOS) remains unclear. Furthermore, whether a diagnosis of PCOS could result in adverse pregnancy and perinatal outcomes in women with different BMIs remains unknown. Material and methods A historical cohort study included 1667 women with PCOS and 12 256 women without PCOS after a freeze‐all policy between January 2016 and December 2020. The outcomes encompassed both pregnancy and perinatal outcomes. Multivariate logistic regression analysis and restricted cubic spline models were performed to eliminate confounding factors when investigating the relationship between BMI and different outcomes. Results After controlling for covariates, pregnancy outcomes were comparable between underweight women with PCOS and normal weight women with PCOS. However, overweight patients had a lower clinical pregnancy rate and an overall live birth rate. Furthermore, patients with obesity had a lower rate of multiple pregnancies but a higher rate of biochemical pregnancy than in the normal BMI group. Additionally, the restricted cubic spline models showed that as maternal BMI increased to 32 kg/m2, the clinical pregnancy rate and live birth rate after blastocyst transfer decreased, but the risks of preterm birth, gestational diabetes mellitus, macrosomia, large‐for‐gestational age (LGA) and very LGA increased in patients with PCOS after a freeze‐all strategy. Moreover, a diagnosis of PCOS resulted in a higher clinical pregnancy rate and live birth rate and a higher risk of small‐for‐gestational age in the normal weight group. However, women with PCOS in the overweight group exhibited higher risks of very preterm birth and gestational diabetes mellitus compared with women without PCOS. Conclusions This study showed that a higher BMI had a detrimental impact on the pregnancy and perinatal outcomes of PCOS patients undergoing a freeze‐all strategy. However, it was only statistically significant in the overweight group. A diagnosis of PCOS had a higher clinical pregnancy rate and live birth rate in normal weight women but higher risks of perinatal complications in normal weight and overweight women.https://doi.org/10.1111/aogs.14771freeze‐all policyperinatal outcomespolycystic ovary syndromepregnancy outcomespre‐pregnancy BMI
spellingShingle Xinyao Hu
Enqi Yan
Wenju Peng
Yueping Zhou
Lei Jin
Kun Qian
Higher pre‐pregnancy body mass index was associated with adverse pregnancy and perinatal outcomes in women with polycystic ovary syndrome after a freeze‐all strategy: A historical cohort study
Acta Obstetricia et Gynecologica Scandinavica
freeze‐all policy
perinatal outcomes
polycystic ovary syndrome
pregnancy outcomes
pre‐pregnancy BMI
title Higher pre‐pregnancy body mass index was associated with adverse pregnancy and perinatal outcomes in women with polycystic ovary syndrome after a freeze‐all strategy: A historical cohort study
title_full Higher pre‐pregnancy body mass index was associated with adverse pregnancy and perinatal outcomes in women with polycystic ovary syndrome after a freeze‐all strategy: A historical cohort study
title_fullStr Higher pre‐pregnancy body mass index was associated with adverse pregnancy and perinatal outcomes in women with polycystic ovary syndrome after a freeze‐all strategy: A historical cohort study
title_full_unstemmed Higher pre‐pregnancy body mass index was associated with adverse pregnancy and perinatal outcomes in women with polycystic ovary syndrome after a freeze‐all strategy: A historical cohort study
title_short Higher pre‐pregnancy body mass index was associated with adverse pregnancy and perinatal outcomes in women with polycystic ovary syndrome after a freeze‐all strategy: A historical cohort study
title_sort higher pre pregnancy body mass index was associated with adverse pregnancy and perinatal outcomes in women with polycystic ovary syndrome after a freeze all strategy a historical cohort study
topic freeze‐all policy
perinatal outcomes
polycystic ovary syndrome
pregnancy outcomes
pre‐pregnancy BMI
url https://doi.org/10.1111/aogs.14771
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