近日，荷兰阿姆斯特丹大学医学中心Anne W. T. van der Wel团队研究了补充肌醇预防多囊卵巢综合征妊娠并发症的疗效。2025年9月8日出版的《美国医学会杂志》发表了这项成果。

患有多囊卵巢综合征（PCOS）的孕妇出现妊娠并发症的风险较高，包括妊娠糖尿病、先兆子痫和早产。补充肌醇可以降低这些风险。

为了确定PCOS患者妊娠期间每日补充肌醇是否能降低妊娠糖尿病、子痫前期和早产的综合风险，研究组在荷兰的13家医院进行了一项双盲、安慰剂对照、随机试验。2019年6月至2023年3月期间招募妊娠8至16周的多囊卵巢综合征孕妇。最终随访于2023年12月27日完成。分析于2024年7月进行。参与者以1:1的比例随机接受含有2克肌醇和0.2毫克叶酸的小袋，每天两次（n = 230) 或仅将安慰剂与0.2mg叶酸相匹配（n = 234) 直到分娩。主要结局是妊娠期糖尿病、先兆子痫或早产（妊娠37周前）的综合结果。

在464名参与者中，平均（SD）年龄为31.5（3.8）岁；18名参与者（3.9%）报告为亚裔，395名（86.1%）报告为白人。肌醇组基线时生化高雄激素血症的患病率高于安慰剂组（29.0%[180/53] vs 18.5%[193]）。主要结局事件发生率肌醇组为25.0%（n = 56) ，安慰剂组为26.8%（n = 61) （相对风险，0.93[95%CI，0.68-1.28]；P = .67）。

研究结果表明，妊娠期补充肌醇并不能降低多囊卵巢综合征患者妊娠期糖尿病、子痫前期或早产的复合发病率。

附：英文原文

Title: Myo-inositol Supplementation to Prevent Pregnancy Complications in Polycystic Ovary Syndrome: A Randomized Clinical Trial

Author: Anne W. T. van der Wel, Chryselle M. C. Frank, Rebekka Bout-Rebel, Ruben G. Duijnhoven, Bo E. van Bree, Olivier Valkenburg, Salwan Al-Nasiry, Robbert H. F. van Oppenraaij, Tatjana E. Vogelvang, Michelle E. M. H. Westerhuis, Hedwig P. van de Nieuwenhof, Susanne C. J. P. Gielen, Myrthe L. Bandell, Mireille N. Bekker, Maurice G. A. J. Wouters, Velja Mijatovic, Arie Franx, Cornelis B. Lambalk, Frank J. M. Broekmans, Sabina de Weerd, Jet M. H. Gerards, Jelle H. Baalman, Jeroen van Disseldorp, Josje Langenveld, Marlise N. Gunning, Geert W. J. Frederix, Rebecca C. Painter, Bart C. J. M. Fauser, Joop S. E. Laven, Bas B. van Rijn

Issue&Volume: 2025-09-08

Abstract:

Importance  Pregnant individuals with polycystic ovary syndrome (PCOS) present with a higher risk of pregnancy complications, including gestational diabetes, preeclampsia, and preterm birth. Myo-inositol supplementation may reduce these risks.

Objective  To determine whether daily supplementation with myo-inositol during pregnancy among individuals with PCOS reduces the risk of a composite outcome of gestational diabetes, preeclampsia, and preterm birth.

Design, Setting, and Participants  This double-blind, placebo-controlled, randomized trial was conducted at 13 hospitals in the Netherlands. Pregnant individuals with PCOS who were between 8 and 16 weeks’ gestation were enrolled between June 2019 and March 2023. Final follow-up was complete on December 27, 2023. Analyses were conducted July 2024.

Interventions  Participants were randomized on a 1:1 basis to receive sachets with either myo-inositol, 2 g, with 0.2 mg of folic acid twice daily (n=230) or matching placebo with 0.2 mg of folic acid only (n=234) until delivery.

Main Outcomes and Measures  The primary outcome was a composite of gestational diabetes, preeclampsia, or preterm birth (before 37 weeks’ gestation).

Results  Among 464 participants, the mean (SD) age was 31.5 (3.8) years; 18 participants (3.9%) reported Asian race and 395 (86.1%) reported White race. The prevalence of biochemical hyperandrogenism was higher at baseline in the myo-inositol group than the placebo group (29.0% [53 of 180] vs 18.5% [37 of 193]). A primary outcome event occurred in 25.0% (n=56) of participants in the myo-inositol group and 26.8% (n=61) in the placebo group (relative risk, 0.93 [95% CI, 0.68-1.28]; P=.67).

Conclusions and Relevance  Myo-inositol supplementation during pregnancy did not reduce the incidence of a composite of gestational diabetes, preeclampsia, or preterm birth in patients with PCOS.

DOI: 10.1001/jama.2025.13668

Source: https://jamanetwork.com/journals/jama/fullarticle/2838634