Association between Pre-Pregnancy Overweightness/Obesity and Pregnancy Outcomes in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Search Strategy
2.2. Inclusion and Exclusion Criteria
2.3. Data Extraction and Risk of Bias Assessment
2.4. Statistical Analysis
3. Results
3.1. Study Selection
3.2. Study Characteristics
Study [Reference], Year (Country) | Study Design | Study Population | Outcome | PCOS Criteria | Con Method | Detail of Con Method | NOS Score | ||||
---|---|---|---|---|---|---|---|---|---|---|---|
BMI (kg/m2) | Sample Size | Age(y) | Miscarriage A: Definition of Miscarriage B: Definition of Miscarriage (M) Rate | Live Birth A: Definition of Live Birth B: Definition of Live Birth (L) Rate | Preterm Birth A: Definition of Preterm Birth B: Definition of Preterm Birth (P) Rate | ||||||
Hamilton-Fairley et al. [40]. 1992 (UK) | RC | ≧25.0, <28 | 25 | 30.9 ± 3.7 | A: not mentioned B: M/positive pregnancy test | Adams (US) | OI | Gonadotrophin | 9 | ||
≧19, <25 | 75 | 29.8 ± 4.3 | |||||||||
McCormick et al. [15]. 2008 (USA) | RC | ≧30 | 10 | 31.5 ± 5.0 | A: GA < 20 weeks B: M/positive pregnancy test | A: alive newborn B: L/egg retrievals | Rot | IVF | GnRH agonist protocol (97.9%); GnRH-anta protocol (2.1%) | 9 | |
≧18.5, <30 | 6 | 31.5 ± 3.0 | |||||||||
Ozgun et al. [19]. 2011 (Turkey) | PC | ≧30 | 18 | 26.7 ± 2.9 | A: GA < 20 weeks B: M/clinical pregnancy | A: not mentioned B: L/all patients | Rot | ICSI | Long protocol | 8 | |
<30 | 26 | 26.8 ± 4.5 | |||||||||
Shalom-Paz et al. [13]. 2011 (Canada) | RC | ≧35, | 13 | 29.6 ± 1.0 | A: not mentioned B: M/clinical pregnancy | A: not mentioned B: L/clinical pregnancy | Rot | IVF | Not mentioned | 7 | |
≧30, <35 | 12 | 31.0 ± 0.9 | |||||||||
≧25, <30 | 24 | 31.2 ± 0.7 | |||||||||
≧20, <25 | 50 | 30.8 ± 0.4 | |||||||||
<20 | 17 | 31.3 ± 0.8 | |||||||||
De Frène et al. [34]. 2014 (Belgium) | RC | >25 | 93 | 29.0 ± 4.2 | A: GA < 25 weeks B: M/positive hCG at GA 4 weeks | A: GA < 37 weeks B: P/live birth | Rot | Any | Not mentioned | 8 | |
≦25 | 107 | 28.4 ± 3.1 | |||||||||
Huang et al. [21]. 2014 (China) | RC | ≧24 | 49 | 30.5 ± 4.1 | A: not mentioned B: M/clinical pregnancy | A: alive and survived > 1 month B: L/all patients | Rot | IVF/ICSI | Not mentioned | 7 | |
<24 | 79 | 29.4 ± 3.4 | |||||||||
Bailey et al. [35]. 2014 (USA) | RC | ≧30 | 31 | 32.4 ± 3.2 | A: GA < 20 weeks B: M/FET cycles | A: alive newborn B: L/FET cycles | Rot | IVF/ICSI | Not mentioned | 8 | |
≧25, <30 | 19 | 32.6 ± 2.9 | |||||||||
≧18.7, <25 | 51 | 32.0 ± 3.5 | |||||||||
Cui et al. [20]. 2016 (China) | RC | ≧28 | 88 | 27.50 ± 3.4 | A: GA < 20 weeks B: M/clinical pregnancy | A: not mentioned B: P/clinical pregnancy | Rot | IVF/ICSI | Long protocol | 6 | |
≧24, <28 | 125 | 27.50 ± 3.1 | |||||||||
≧18.5, <24 | 183 | 26.99 ± 2.9 | |||||||||
<18.5 | 12 | 27.33 ± 3.3 | |||||||||
Sheng et al. [12]. 2017 (China) | PC | ≧28 | 63 | 28.7 ± 2.7 | A: <1 st trimester B: M/clinical pregnancy | Rot | IVF/ICSI | Long protocol | 7 | ||
≧24, <28 | 211 | 28.5 ± 3.1 | |||||||||
≧18.5, <24 | 449 | 27.7 ± 3.1 | |||||||||
<18.5 | 51 | 26.3 ± 3.1 | |||||||||
Pan et al. [14]. 2018 (China) | RC | ≧28 | 102 | 29.77 ± 3.5 | A: GA < 28 weeks B: M/ET | A: alive newborn B: L/ET | A: GA 28~37 weeks B: P/ET | Rot | IVF | Long protocol | 6 |
≧24, <28 | 315 | 29.45 ± 3.5 | |||||||||
≧18.5, <24 | 606 | 29.08 ± 3.2 | |||||||||
<18.5 | 51 | 27.78 ± 3.1 | |||||||||
Yang et al. [36]. 2018 (China) | RC | ≥25 | 213 | 29.5 | A: not mentioned B: M/clinical pregnancy | A: not mentioned B: not mentioned | A: not mentioned B: P/clinical pregnancy | Rot | IVF | GnRH-anta protocol | 7 |
<25 | 370 | 29.1 | |||||||||
Chen et al. [39]. 2018 (China) | RC | ≥24 | 138 | 28.9 ± 3.0 | A: GA < 12 weeks B: M/clinical pregnancy | A: not mentioned B: L/all patients | A: not mentioned B: P/live birth | Rot | IVF | GnRH-anta protocol | 7 |
<24 | 260 | 28.8 ± 2.7 | |||||||||
Lin et al. [16]. 2019 (China) | RC | ≧30 | 228 | 33.27 ± 3.6 | A: not mentioned B: M/clinical pregnancy | A: alive at GA ≥ 24 weeks B: L/FET cycles | A: <37 weeks B: P/FET cycles | Rot | IVF/ICSI | GnRH-anta protocol; mild stimulation; PPOS (Percentage not mentioned) | 7 |
≧25.0, <30 | 480 | 33.09 ± 3.8 | |||||||||
≧18.5, <25 | 972 | 32.82 ± 3.4 | |||||||||
Qiu et al. [18]. 2019 (China) | RC | ≧30 | 204 | 30.05 ± 3.6 | A: <1 st trimester B: M/clinical pregnancy | A: alive at GA ≥24 weeks B: L/FET cycles | Rot | IVF/ICSI with freeze all | GnRH-anta protocol | 6 | |
≧25, <30 | 780 | 30.48 ± 3.9 | |||||||||
≧18.5, <25 | 1911 | 29.97 ± 3.3 | |||||||||
<18.5 | 184 | 28.91 ± 3.2 | |||||||||
Zhou et al. [17]. 2020 (China) | RC | ≧30 | 198 | 27.97 ± 3.0 | A: not mentioned B: M/clinical pregnancy | A: not mentioned B: not mentioned | A: not mentioned B: not mentioned | Rot | IVF/ICSI | Ultra-long protocol | 7 |
≧25, <30 | 742 | 28.19 ± 3.1 | |||||||||
≧18.5, <25 | 800 | 28.13 ± 3.1 | |||||||||
<18.5 | 42 | 27.76 ± 2.5 | |||||||||
Guan et al. [38]. 2021 (China) | RC | ≧28 | 194 | not mentioned | A: not mentioned B: M/clinical pregnancy | A: not mentioned B: L/clinical pregnancy | Rot | OI with IUI | CC (3.9%); LE (18.1%); hMG (11.3%); hMG + CC(17.8%); hMG + LE (48.9%) | 7 | |
≧24, <28 | 321 | ||||||||||
≧18.5, <24 | 299 | ||||||||||
<18.5 | 17 |
3.3. Miscarriage
3.4. Live Birth
3.5. Preterm Birth (PB)
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Acknowledgments
Conflicts of Interest
References
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Yang, S.-T.; Liu, C.-H.; Ma, S.-H.; Chang, W.-H.; Chen, Y.-J.; Lee, W.-L.; Wang, P.-H. Association between Pre-Pregnancy Overweightness/Obesity and Pregnancy Outcomes in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health 2022, 19, 9094. https://doi.org/10.3390/ijerph19159094
Yang S-T, Liu C-H, Ma S-H, Chang W-H, Chen Y-J, Lee W-L, Wang P-H. Association between Pre-Pregnancy Overweightness/Obesity and Pregnancy Outcomes in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health. 2022; 19(15):9094. https://doi.org/10.3390/ijerph19159094
Chicago/Turabian StyleYang, Szu-Ting, Chia-Hao Liu, Sheng-Hsiang Ma, Wen-Hsun Chang, Yi-Jen Chen, Wen-Ling Lee, and Peng-Hui Wang. 2022. "Association between Pre-Pregnancy Overweightness/Obesity and Pregnancy Outcomes in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis" International Journal of Environmental Research and Public Health 19, no. 15: 9094. https://doi.org/10.3390/ijerph19159094