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Journal of Zhejiang University SCIENCE B 2020 Vol.21 No.12 P.977-989

http://doi.org/10.1631/jzus.B2000350


Fetal growth, fetal development, and placental features in women with polycystic ovary syndrome: analysis based on fetal and placental magnetic resonance imaging


Author(s):  Qing Zhang, Zhong-kun Bao, Mei-xiang Deng, Qiong Xu, Dan-dan Ding, Man-man Pan, Xi Xi, Fang-fang Wang, Yu Zou, Fan Qu

Affiliation(s):  School of Obstetrics and Gynecology, Zhejiang University School of Medicine, Hangzhou 310006, China; more

Corresponding email(s):   syqufan@zju.edu.cn

Key Words:  Polycystic ovary syndrome (PCOS), Fetus, Magnetic resonance imaging (MRI), Growth and development, Placenta


Qing Zhang, Zhong-kun Bao, Mei-xiang Deng, Qiong Xu, Dan-dan Ding, Man-man Pan, Xi Xi, Fang-fang Wang, Yu Zou, Fan Qu. Fetal growth, fetal development, and placental features in women with polycystic ovary syndrome: analysis based on fetal and placental magnetic resonance imaging[J]. Journal of Zhejiang University Science B, 2020, 21(12): 977-989.

@article{title="Fetal growth, fetal development, and placental features in women with polycystic ovary syndrome: analysis based on fetal and placental magnetic resonance imaging",
author="Qing Zhang, Zhong-kun Bao, Mei-xiang Deng, Qiong Xu, Dan-dan Ding, Man-man Pan, Xi Xi, Fang-fang Wang, Yu Zou, Fan Qu",
journal="Journal of Zhejiang University Science B",
volume="21",
number="12",
pages="977-989",
year="2020",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B2000350"
}

%0 Journal Article
%T Fetal growth, fetal development, and placental features in women with polycystic ovary syndrome: analysis based on fetal and placental magnetic resonance imaging
%A Qing Zhang
%A Zhong-kun Bao
%A Mei-xiang Deng
%A Qiong Xu
%A Dan-dan Ding
%A Man-man Pan
%A Xi Xi
%A Fang-fang Wang
%A Yu Zou
%A Fan Qu
%J Journal of Zhejiang University SCIENCE B
%V 21
%N 12
%P 977-989
%@ 1673-1581
%D 2020
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B2000350

TY - JOUR
T1 - Fetal growth, fetal development, and placental features in women with polycystic ovary syndrome: analysis based on fetal and placental magnetic resonance imaging
A1 - Qing Zhang
A1 - Zhong-kun Bao
A1 - Mei-xiang Deng
A1 - Qiong Xu
A1 - Dan-dan Ding
A1 - Man-man Pan
A1 - Xi Xi
A1 - Fang-fang Wang
A1 - Yu Zou
A1 - Fan Qu
J0 - Journal of Zhejiang University Science B
VL - 21
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SP - 977
EP - 989
%@ 1673-1581
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PB - Zhejiang University Press & Springer
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DOI - 10.1631/jzus.B2000350


Abstract: 
Objective: polycystic ovary syndrome (PCOS), a common endocrine-metabolic dysfunction in reproductive-aged women, may be involved in compromised pregnancy and offspring outcomes. This study aimed to investigate whether maternal PCOS affects fetal growth, fetal development, and placental features. Methods: This retrospective case-control study included 60 pregnant women with PCOS (PCOS group) and 120 healthy pregnant women without PCOS (control group). Fetal magnetic resonance imaging (MRI) was performed followed by an ultrasound examination and indications for imaging, including known or suspected fetal pathology, history of fetal abnormality in previous pregnancy or in a family member, and concern for placenta accreta. Fetal MRI images were analyzed for head circumference (HC), abdomen circumference (AC), lung-to-liver signal intensity ratio (LLSIR, a prenatal marker of fetal lung maturity), lengths of liver and kidney diameters in fetuses, and placental relative signal intensity on T2-weighted single-shot fast spin echo (SSFSE) imaging (rSISSFSE), and placental relative apparent diffusion coefficient value (rADC). Data on height and weight of offspring were collected through telephone follow-up. Results: Compared to the control group, the PCOS group showed the following characteristics: (1) smaller biparietal diameter and femur length in fetuses (P=0.026 and P=0.005, respectively), (2) smaller HC in fetuses (evident after 32 weeks; P=0.044), (3) lower LLSIR and smaller dorsoventral length of liver in fetuses (evident before 32 weeks; P=0.005 and P=0.019, respectively), and (4) smaller placental thickness (evident before 32 weeks; P=0.017). No significant differences in placental rSISSFSE or rADC were observed between the groups (all P>0.05). No significant differences in height and weight of offspring during childhood existed between the groups (all P>0.05). Conclusions: There exist alterations of fetal growth, fetal development, and placental features from women with PCOS.

多囊卵巢综合征女性孕期的胎儿生长发育和胎盘特征:基于胎儿和胎盘磁共振成像分析

目的:探讨母亲多囊卵巢综合征(PCOS)对子代胎儿期生长发育和胎盘特征的影响.
创新点:首次关注到PCOS女性孕期的胎儿和胎盘磁共振成像(MRI)特征,通过影像学和临床疾病的结合,对胎儿和胎盘MRI图像进行全面分析和测量,评估胎儿生长发育和胎盘特征,并追踪产科和子代随访结局,以期为PCOS对子代的潜在影响提供科学依据.
方法:本研究对浙江大学医学院附属妇产科医院2013~2018年行胎儿MRI检查的妊娠女性病例行回顾性分析,根据鹿特丹诊断标准纳入PCOS妊娠女性60例,随机选取与其胎儿MRI检查孕周相匹配的非PCOS妊娠女性120例作为对照,收集胎儿和胎盘MRI图像信息,统计学分析比较PCOS妊娠女性与非PCOS妊娠女性影像学测量指标,包括胎儿的双顶径、头围、腹围、肝脏和肾脏各径线,胎儿肺和肝的信号强度,胎盘异常情况、胎盘厚度、胎盘信号强度和表观扩散系数值(ADC),并比较分析人口学数据、产科和新生儿结局,随访子代儿童期的生长情况.
结论:母亲PCOS会造成子代胎儿期生长发育和胎盘特征的改变.因本研究为回顾性研究、样本量偏小及一些潜在的偏差,结论有待进一步证实.

关键词:多囊卵巢综合征;胎儿;核磁共振成像;生长发育;胎盘

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

Reference

[1]Ahlsson FSE, Diderholm B, Ewald U, et al., 2007. Lipolysis and insulin sensitivity at birth in infants who are large for gestational age. Pediatrics, 120(5):958-965.

[2]Bonel HM, Stolz B, Diedrichsen L, et al., 2010. Diffusion-weighted MR imaging of the placenta in fetuses with placental insufficiency. Radiology, 257(3):810-819.

[3]Bozdag G, Mumusoglu S, Zengin D, et al., 2016. The prevalence and phenotypic features of polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod, 31(12):2841-2855.

[4]Cannie M, Neirynck V, de Keyzer F, et al., 2007. Prenatal magnetic resonance imaging demonstrates linear growth of the human fetal kidneys during gestation. J Urol, 178(4S):1570-1574.

[5]Cesta CE, Öberg AS, Ibrahimson A, et al., 2020. Maternal polycystic ovary syndrome and risk of neuropsychiatric disorders in offspring: prenatal androgen exposure or genetic confounding? Psychol Med, 50(4):616-624.

[6]Committee on Obstetric Practice, 2012. Committee opinion No. 529: placenta accreta. Obstet Gynecol, 120(1):207-211.

[7]Daan NMP, Koster MPH, Steegers-Theunissen RP, et al., 2017. Endocrine and cardiometabolic cord blood characteristics of offspring born to mothers with and without polycystic ovary syndrome. Fertil Steril, 107(1):261-268.e3.

[8]Doherty DA, Newnham JP, Bower C, et al., 2015. Implications of polycystic ovary syndrome for pregnancy and for the health of offspring. Obstet Gynecol, 125(6):1397-1406.

[9]Dumesic DA, Goodarzi MO, Chazenbalk GD, et al., 2014. Intrauterine environment and polycystic ovary syndrome. Semin Reprod Med, 32(3):159-165.

[10]Hales CN, Barker DJ, 2001. The thrifty phenotype hypothesis. Br Med Bull, 60:5-20.

[11]Hamabe Y, Hirose A, Yamada S, et al., 2013. Morphology and morphometry of fetal liver at 16–26 weeks of gestation by magnetic resonance imaging: comparison with embryonic liver at Carnegie stage 23. Hepatol Res, 43(6):639-647.

[12]Han AR, Kim HO, Cha SW, et al., 2011. Adverse pregnancy outcomes with assisted reproductive technology in non-obese women with polycystic ovary syndrome: a case-control study. Clinical Exp Reprod Med, 38(2):103-108.

[13]Himoto Y, Kido A, Mogami H, et al., 2016. Placental function assessed visually using half-Fourier acquisition single-shot turbo spin-echo (HASTE) magnetic resonance imaging. Placenta, 39:55-60.

[14]Hjorth-Hansen A, Salvesen Ø, Hanem LGE, et al., 2018. Fetal growth and birth anthropometrics in metformin-exposed offspring born to mothers with PCOS. J Clin Endocrinol Metab, 103(2):740-747.

[15]Kelley AS, Smith YR, Padmanabhan V, 2019. A narrative review of placental contribution to adverse pregnancy outcomes in women with polycystic ovary syndrome. J Clin Endocrinol Metab, 104(11):5299-5315.

[16]Kim MA, Han GH, Kim YH, 2019. Prediction of small-for-gestational age by fetal growth rate according to gestational age. PLoS ONE, 14(4):e0215737.

[17]Kiserud T, Piaggio G, Carroli G, et al., 2017. The World Health Organization fetal growth charts: a multinational longitudinal study of ultrasound biometric measurements and estimated fetal weight. PLoS Med, 14(1):e1002220.

[18]Kjerulff LE, Sanchez-Ramos L, Duffy D, 2011. Pregnancy outcomes in women with polycystic ovary syndrome: a metaanalysis. Am J Obstet Gynecol, 204(6):558.e1-558.e6.

[19]Kosova G, Urbanek M, 2013. Genetics of the polycystic ovary syndrome. Mol Cell Endocrinol, 373(1-2):29-38.

[20]Koster MPH, de Wilde MA, Veltman-Verhulst SM, et al., 2015. Placental characteristics in women with polycystic ovary syndrome. Hum Reprod, 30(12):2829-2837.

[21]Li R, Zhang QF, Yang DZ, et al., 2013. Prevalence of polycystic ovary syndrome in women in China: a large community-based study. Hum Reprod, 28(9):2562-2569.

[22]Longtine MS, Nelson DM, 2011. Placental dysfunction and fetal programming: the importance of placental size, shape, histopathology, and molecular composition. Semin Reprod Med, 29(3):187-196.

[23]Mailath-Pokorny M, Polterauer S, Worda K, et al., 2015. Isolated short fetal femur length in the second trimester and the association with adverse perinatal outcome: experiences from a tertiary referral center. PLoS ONE, 10(6):e0128820.

[24]Maliqueo M, Lara HE, Sánchez F, et al., 2013. Placental steroidogenesis in pregnant women with polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol, 166(2):151-155.

[25]Maliqueo M, Poromaa IS, Vanky E, et al., 2015. Placental STAT3 signaling is activated in women with polycystic ovary syndrome. Hum Reprod, 30(3):692-700.

[26]McDonnell R, Hart RJ, 2017. Pregnancy-related outcomes for women with polycystic ovary syndrome. Womens Health (Lond), 13(3):89-97.

[27]Mehrabian F, Kelishadi R, 2012. Comparison of the metabolic parameters and androgen level of umbilical cord blood in newborns of mothers with polycystic ovary syndrome and controls. J Res Med Sci, 17(3):207-211.

[28]Palomba S, Russo T, Falbo A, et al., 2013. Macroscopic and microscopic findings of the placenta in women with polycystic ovary syndrome. Hum Reprod, 28(10):2838-2847.

[29]Palomba S, Falbo A, Chiossi G, et al., 2014a. Early trophoblast invasion and placentation in women with different PCOS phenotypes. Reprod Biomed Online, 29(3):370-381.

[30]Palomba S, Falbo A, Chiossi G, et al., 2014b. Low-grade chronic inflammation in pregnant women with polycystic ovary syndrome: a prospective controlled clinical study. J Clin Endocrinol Metab, 99(8):2942-2951.

[31]Palomba S, de Wilde MA, Falbo A, et al., 2015. Pregnancy complications in women with polycystic ovary syndrome. Hum Reprod Update, 21(5):575-592.

[32]Paltiel O, Tikellis G, Linet M, et al., 2015. Birthweight and childhood cancer: preliminary findings from the International Childhood Cancer Cohort Consortium (I4C). Paediatr Perinat Epidemiol, 29(4):335-345.

[33]Pan XF, Tang L, Lee AH, et al., 2019. Association between fetal macrosomia and risk of obesity in children under 3 years in Western China: a cohort study. World J Pediatr, 15(2):153-160.

[34]Pan XM, Lin Z, Li N, et al., 2018. Effects of body mass index on the outcomes of in vitro fertilization in Chinese patients with polycystic ovary syndrome: a retrospective cohort study. J Zhejiang Univ-Sci B (Biomed & Biotechnol), 19(6):490-496.

[35]Prayer D, Malinger G, Brugger PC, et al., 2017. ISUOG Practice Guidelines: performance of fetal magnetic resonance imaging. Ultrasound Obstet Gynecol, 49(5):671-680.

[36]Pugash D, Brugger PC, Bettelheim D, et al., 2008. Prenatal ultrasound and fetal MRI: the comparative value of each modality in prenatal diagnosis. Eur J Radiol, 68(2):214-226.

[37]Risnes KR, Vatten LJ, Baker JL, et al., 2011. Birthweight and mortality in adulthood: a systematic review and meta-analysis. Int J Epidemiol, 40(3):647-661.

[38]Roberts AB, Mitchell J, Murphy C, et al., 1994. Fetal liver length in diabetic pregnancy. Am J Obstet Gynecol, 170(5):1308-1312.

[39]Sir-Petermann T, Hitchsfeld C, Maliqueo M, et al., 2005. Birth weight in offspring of mothers with polycystic ovarian syndrome. Hum Reprod, 20(8):2122-2126.

[40]Skiba MA, Islam RM, Bell RJ, et al., 2018. Understanding variation in prevalence estimates of polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update, 24(6):694-709.

[41]The Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group, 2004. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril, 81(1):19-25.

[42]Thornburg KL, Kolahi K, Pierce M, et al., 2016. Biological features of placental programming. Placenta, 48(S1):S47-S53.

[43]Whitehouse AJ, Maybery MT, Hart R, et al., 2010. Free testosterone levels in umbilical-cord blood predict infant head circumference in females. Dev Med Child Neurol, 52(3):e73-e77.

[44]Wissing ML, Bjerge MR, Olesen AIG, et al., 2014. Impact of PCOS on early embryo cleavage kinetics. Reprod Biomed Online, 28(4):508-514.

[45]Yamoto M, Iwazaki T, Takeuchi K, et al., 2018. The fetal lung-to-liver signal intensity ratio on magnetic resonance imaging as a predictor of outcomes from isolated congenital diaphragmatic hernia. Pediatr Surg Int, 34(2):161-168.

[46]Yu HF, Chen HS, Rao DP, et al., 2016. Association between polycystic ovary syndrome and the risk of pregnancy complications: a PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore), 95(51):e4863.

[47]Zhu YH, Qu F, 2018. Towards a multidimensional scientific approach to improve clinical practices for infertility treatment. J Zhejiang Univ-Sci B (Biomed & Biotechnol), 19(11):815-817.

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