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Metabolic syndrome and time to pregnancy: a retrospective study of nulliparous women

Grieger, JA ; Grzeskowiak, LE ; Smithers, LG ; Bianco‐Miotto, T ; Leemaqz, SY ; Andraweera, P ; Poston, L ; McCowan, LM ; Kenny, LC ; Myers, J ; Walker, JJ ; Norman, RJ ; Dekker, GA ; Roberts, CT

BJOG : an international journal of obstetrics and gynaecology, 2019-06, Vol.126 (7), p.852-862 [Periódico revisado por pares]

England: Wiley Subscription Services, Inc

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  • Título:
    Metabolic syndrome and time to pregnancy: a retrospective study of nulliparous women
  • Autor: Grieger, JA ; Grzeskowiak, LE ; Smithers, LG ; Bianco‐Miotto, T ; Leemaqz, SY ; Andraweera, P ; Poston, L ; McCowan, LM ; Kenny, LC ; Myers, J ; Walker, JJ ; Norman, RJ ; Dekker, GA ; Roberts, CT
  • Assuntos: Adult ; Australia - epidemiology ; Body Mass Index ; Cholesterol ; Diabetes mellitus ; Fecundity ; Female ; Gestation ; High density lipoprotein ; Humans ; Infertility ; Infertility, Female - epidemiology ; Ireland - epidemiology ; lipids ; Metabolic syndrome ; Metabolic Syndrome - epidemiology ; New Zealand - epidemiology ; Obesity ; Parity - physiology ; Pregnancy ; Retrospective Studies ; retrospective study ; Risk assessment ; time to pregnancy ; Time-to-Pregnancy - physiology ; Triglycerides ; United Kingdom - epidemiology ; Womens health
  • É parte de: BJOG : an international journal of obstetrics and gynaecology, 2019-06, Vol.126 (7), p.852-862
  • Notas: https://doi.org/10.1111/1471-0528.15669
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  • Descrição: Objective To determine: (1) the association between metabolic syndrome (MetS), time to pregnancy (TTP), and infertility; (2) associations between individual and an increasing number of MetS components, TTP, and infertility; and (3) whether these relationships differ by body mass index (BMI < 30 kg/m2 versus BMI ≥ 30 kg/m2). Design Retrospective cohort study. Setting Multiple centres (in Australia, Ireland, New Zealand, and the UK). Population Five thousand five hundred and nineteen low‐risk nulliparous pregnant women. Methods Data on retrospectively reported TTP (number of months to conceive) and a blood sample to assess metabolic health were collected between 14 and 16 weeks of gestation. MetS was defined according to the International Diabetes Federation criteria. Accelerated failure time models with log‐normal distribution were conducted to estimate time ratios (TRs) and 95% CIs. Differences in MetS on infertility (TTP > 12 months) were compared using a generalised linear model (Poisson distribution) with robust variance estimates (relative risks, RRs; 95% CIs). All analyses (entire cohort and split by BMI) were controlled for a range of maternal and paternal confounding factors. Main outcome measures Time to pregnancy and infertility. Results Of the 5519 women included, 12.4% (n = 684) had MetS. Compared with women without MetS, women with MetS had a longer TTP (adjusted TR 1.30; 95% CI 1.15–1.46), which was similar in women who were obese and in women who were not obese. Marginal estimates for median TTP in women with MetS versus without MetS was 3.1 months (3.0–3.3 months) versus 4.1 months (3.6–4.5 months), respectively. Women with MetS were at a 62% greater risk for infertility and were at a greater risk for infertility whether they were obese (adjusted RR 1.62; 95% CI 1.15–2.29) or not (adjusted RR 1.73; 95% CI 1.33–2.23). Reduced high‐density lipoprotein cholesterol (HDL‐C) and raised triglycerides (TGs) were the main individual components associated with risk for infertility. Conclusion Metabolic syndrome is associated with longer TTP and infertility, independent of obesity. Additional studies, before pregnancy, are required to support our findings and to determine the applicability of which combinations of metabolic abnormalities pose the greatest risk to delayed fertility, or whether individual components are amenable to modification. Tweetable Metabolic syndrome is associated with longer time to pregnancy and infertility, independent of obesity. Tweetable Metabolic syndrome is associated with longer time to pregnancy and infertility, independent of obesity.
  • Editor: England: Wiley Subscription Services, Inc
  • Idioma: Inglês
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