Pregnancy Complications in Women with Polycystic Ovary Syndrome

Boomsma, Carolien M.; Fauser, Bart C.J.M.; Macklon, Nick S.

doi:10.1055/s-2007-992927

Cited by 162 publications

(112 citation statements)

References 73 publications

(117 reference statements)

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“…The increased risk of early pregnancy loss has been attributed to treatment with ovulation-inducing agents, raised androgen levels, insulin resistance and obesity [23]. We examined the differences in maternal characteristics between successful pregnancies and miscarriages.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy complications and glucose intolerance in women with polycystic ovary syndrome

et al. 2015

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POLYCYSTIC OVARY SYNDROME (PCOS) is a common endocrine and metabolic disorder present in 5-15% of women of reproductive age depending on the diagnostic criteria used [1,2]. The common features of PCOS are hyperandrogenism, irregular menstruation and polycystic ovaries by ultrasonography [3,4]. In addition, insulin resistance, hyperandrogenism and obesity might play important roles in the pathophysiologic process of PCOS, and the interaction of these factors might result in an increased risk of not only type 2 diabetes mellitus, metabolic syndrome and cardiovascular disease [5][6][7] Abstract. Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by insulin resistance and hyperandrogenism. The interaction of these factors might result in increased risks of miscarriage and pregnancy complications such as gestational diabetes mellitus (GDM). To examine the pregnancy risks in women with PCOS, we compared obstetrical outcomes between patients with and without PCOS. We also studied the differences in maternal characteristics, glucose intolerance and pregnancy complications between PCOS patients with and without GDM, with and without obesity, and between successful pregnancies and miscarriages. We observed a high incidence of GDM and prevalence of GDM diagnosis in the first trimester in PCOS. Patients with GDM had higher body mass index (BMI) and lower homeostasis model assessment of β-cell function (HOMA-β) at preconception than those without GDM. Obese pregnant women with PCOS demonstrated a high incidence of GDM with severe insulin resistance, including high fasting insulin, HOMA of insulin resistance (HOMA-IR), and HOMA-β at preconception compared with normal-weight patients. BMI was significantly correlated with HOMA-IR or HOMA-β, and both indices were lower in PCOS patients with than without GDM for the same BMI. There were no significant differences in maternal characteristics (excluding maternal age) between PCOS patients with successful pregnancy and PCOS patients with miscarriages. Our data suggest that pregnant women with PCOS have an increased risk of GDM, especially if they have obesity and/or poorer insulin secretion. Measure of β-cell function, such as HOMA-β, at preconception might be a useful predictor of the risk of GDM in pregnant PCOS patients.Key words: Polycystic ovary syndrome, Insulin resistance, Pregnancy complication, Gestational diabetes mellitus gestational diabetes mellitus (GDM) [8].Because insulin resistance and obesity might affect the course of pregnancy in women with PCOS, we compared the obstetrical outcomes between the patients with PCOS and without PCOS. We also examined the differences in maternal characteristics and perinatal outcomes between PCOS patients with and without GDM and with and without obesity. Furthermore, we examined the differences in maternal characteristics between successful pregnancies and miscarriages to determine the risks of pregnancy loss in women with PCOS. Materials and MethodsA total of 64 Japanese pregnant women with PCOS (includ...

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Section: Discussionmentioning

confidence: 99%

Pregnancy complications and glucose intolerance in women with polycystic ovary syndrome

et al. 2015

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“…These may include uterine anomalies [28], uterine leimyomata [29], hormonal imbalances specifically PCOS [30], the vanishing twin syndrome [31], low ovarian reserve [32] as well as thrombophilia [33]. Most of these factors are encountered in fertile as well as infertile populations making their investigation and total isolation as well as their impact on perinatal risks more complex.…”

Section: Discussionmentioning

confidence: 99%

Reduced protein C Global assay level in infertile women prior to IVF-ET treatment

Younis

Ben‐Ami

Izhaki

et al. 2013

J Assist Reprod Genet

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Purpose In the last few years more robust evidence is emerging to point out at an increased rate of prematurity and low birth weight in singleton pregnancies following ART. Whether this increased rate is related to ART practice or to infertility per se, is still an open question. Our aim in this study was to explore this question by evaluating Protein C (ProC) Global assay in infertile women before ART treatment. Methods A cohort of 95 unselected and consecutive infertile women, eligible for ART, was prospectively recruited for the study. The control group included 77 matched healthy fertile women with a history of spontaneous conceptions. Pro C Global assay was evaluated in both groups. A full thrombophilic work-up was performed in the study group.Results ProC Global assay level was found to be significantly lower in the study as compared to the control group, corresponding to 0.78 ± 0.16 and 0.88 ± 0.16, respectively (P <0.01). As well, abnormal ProC Global assay level of ≤0.8 was significantly higher in the study as compared to control group corresponding to 53 % and 29 %, respectively. ProC Global assay level was significantly lower in women within the study group found to have APCR, factor V Leiden and high factor VIII level, any thrombophilia or combined thrombophilia when compared to women without these thrombophilic risk factors. Conclusions Reduced ProC Global assay level is encountered in infertile women prior to ART treatment. This finding may suggest a unique anticoagulation Protein C pathway in infertile as compared to fertile women. Further studies are encouraged to explore this finding.

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“…Obesity, fertility treatments, and other characteristics of patients with PCOS are associated with a higher incidence of pregnancy complications, such as hypertension and preeclampsia (Boomsma et al, 2008). Compared to normal pregnancies, PCOS patients demonstrate a higher incidence of early pregnancy loss (Li et al, 2010).…”

Section: Perinatal Outcome Of Women With Polycystic Ovary Syndrome Anmentioning

confidence: 99%

The Impact of Polycystic Ovarian Syndrome on Gestational Diabetes

Aust¹,

Ott²

2011

Gestational Diabetes

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Pregnancy Complications in Women with Polycystic Ovary Syndrome

Cited by 162 publications

References 73 publications

Pregnancy complications and glucose intolerance in women with polycystic ovary syndrome

Pregnancy complications and glucose intolerance in women with polycystic ovary syndrome

Reduced protein C Global assay level in infertile women prior to IVF-ET treatment

The Impact of Polycystic Ovarian Syndrome on Gestational Diabetes

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