Pre-conception weight loss interventions in women with polycystic ovary syndrome and the effect on perinatal outcomes: A quantitative synthesis of surrogate outcomes.

IF 5.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes, Obesity & Metabolism Pub Date : 2025-10-01 DOI:10.1111/dom.70116

Amelia Fernandes, Adrienne Gordon, Arianne Sweeting

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引用次数: 0

Abstract

Aims: Polycystic ovary syndrome (PCOS) guidelines recommend weight optimisation to improve anthropometric, metabolic and androgenic complications, but data is lacking for pregnancy outcomes.

Materials and methods: We aimed to assess which weight loss interventions improve pregnancy outcomes for women with PCOS and overweight or obesity. A systematic search of Embase, Medline (Ovid) and the Cochrane Clinical Trials Registry for English language articles from database inception until 22 July 2024 was conducted. We included weight loss intervention randomised controlled trials (RCTs) for women with PCOS and body mass index (BMI) ≥25 kg/m². Primary outcomes were pregnancy rates, live births and miscarriages. Secondary outcomes were anthropometric, androgenic, metabolic and other perinatal complications.

Results: Of 9010 articles, 7077 abstracts were screened and 37 RCTs included. One study reported increased pregnancy rates with a 12-month lifestyle intervention versus standard care (23.3%-26.7% vs. 16.7%) (low certainty) but no difference in live birth rate, time to conception or antenatal outcomes. Lifestyle interventions reduced BMI by -0.34 kg/m² (-0.65 to -0.02) on quantitative meta-analysis. Limitations include outcome measure heterogeneity, intervention heterogeneity, inconsistent definitions and low use of core outcome sets.

Conclusions: Limited data on antenatal outcomes highlight a knowledge gap amongst a group at high perinatal risk.

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多囊卵巢综合征妇女孕前减肥干预及其对围产期结局的影响：代孕结果的定量综合

目的：多囊卵巢综合征（PCOS）指南推荐体重优化以改善人体测量、代谢和雄激素并发症，但缺乏有关妊娠结局的数据。材料和方法：我们的目的是评估哪些减肥干预措施可以改善多囊卵巢综合征和超重或肥胖妇女的妊娠结局。系统检索Embase、Medline （Ovid）和Cochrane临床试验注册中心从数据库建立到2024年7月22日的英文文章。我们纳入了体重指数(BMI)≥25 kg/m2的多囊卵巢综合征（PCOS）女性的减肥干预随机对照试验（rct）。主要结局是妊娠率、活产率和流产率。次要结局是人体测量、雄激素、代谢和其他围产期并发症。结果：在9010篇文章中，筛选了7077篇摘要，纳入了37篇rct。一项研究报告，与标准护理相比，12个月生活方式干预增加了妊娠率（23.3%-26.7% vs 16.7%）（低确定性），但在活产率、受孕时间或产前结局方面没有差异。定量荟萃分析显示，生活方式干预使BMI降低-0.34 kg/m2（-0.65至-0.02）。局限性包括结果测量的异质性、干预的异质性、不一致的定义和核心结果集的低使用率。结论：关于产前结局的有限数据突出了围产期高危人群之间的知识差距。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes, Obesity & Metabolism 医学-内分泌学与代谢

CiteScore

10.90

自引率

6.90%

发文量

319

审稿时长

3-8 weeks

期刊介绍： Diabetes, Obesity and Metabolism is primarily a journal of clinical and experimental pharmacology and therapeutics covering the interrelated areas of diabetes, obesity and metabolism. The journal prioritises high-quality original research that reports on the effects of new or existing therapies, including dietary, exercise and lifestyle (non-pharmacological) interventions, in any aspect of metabolic and endocrine disease, either in humans or animal and cellular systems. ‘Metabolism’ may relate to lipids, bone and drug metabolism, or broader aspects of endocrine dysfunction. Preclinical pharmacology, pharmacokinetic studies, meta-analyses and those addressing drug safety and tolerability are also highly suitable for publication in this journal. Original research may be published as a main paper or as a research letter.