Risk for Gestational Diabetes Mellitus and Adverse Birth Outcomes in Chinese Women with Polycystic Ovary Syndrome

Abstract

Objective. To examine the association of polycystic ovary syndrome (PCOS) in early pregnancy with gestational diabetes mellitus (GDM) and adverse birth outcomes. Methods. In this retrospective cohort study including 2389 pregnant women, the medical records of 352 women diagnosed with PCOS were evaluated. Outcomes included GDM, preterm birth, low birth weight, macrosomia, and being small and large for gestational age. Multivariable logistic regression models were used to examine the association of the risk for GDM and adverse birth outcomes with PCOS after adjusting for confounders. Results. Women previously diagnosed with PCOS had a higher risk of GDM (adjusted odds ratio [OR] 1.55, 95% confidence interval [CI]: 1.14–2.09). A strong association was seen between PCOS and preterm birth (adjusted OR 1.69, 95% CI: 1.08–2.67). On stratified analysis, the adjusted OR for GDM among women with PCOS undergoing assisted reproductive technology was 1.44 (95% CI: 1.03–1.92) and among women with PCOS who conceived spontaneously was 1.60 (1.18–2.15). No increased risk for other adverse birth outcomes was observed. Conclusions. Women with PCOS were more likely to experience GDM and preterm birth.

Increased maternal pregnancy complications in polycystic ovary syndrome appear to be independent of obesity—A systematic review, meta‐analysis, and meta‐regression

“…When assessing metabolic disorders in pregnancies, women with PCOS had higher rates of GDM, GHTN, and PE compared with women without PCOS consistent with prior literature . In the general population, obesity, excessive GWG, IR, HA, inflammation, and ethnicity are known risk factors for these disorders with GDM also being an independent risk factor for GHTN and PE . We report the higher prevalence of GDM and GHTN in PCOS were not maintained for non‐hyperandrogenic phenotypes, women from Africa, BMI > 30 kg m −2 and those conceiving after ART although we note the small number of studies for these subgroups (n = 2‐3).…”

“…[8][9][10][11] In the general population, obesity, excessive GWG, IR, HA, inflammation, and ethnicity are known risk factors for these disorders with GDM also being an independent risk factor for GHTN and PE. 66,86,90,[95][96][97][98] We report the higher prevalence of GDM and GHTN in PCOS were not maintained for non-hyperandrogenic phenotypes, women from Africa, BMI > 30 kg m −2 and those conceiving after ART although we note the small number of studies for these subgroups (n = 2-3). Given the 99 Higher hypertensive disorders in GDM affected pregnancies were maintained with a greater odds for women with PCOS suggesting that hypertensive disorders in PCOS likely occur independently from GDM but are worsened by GDM, which is supported by a prior report of oxidative stress profile in PCOS being higher than non-PCOS but similar to GDM.…”

“…Outcomes of interest were reported in a total of n = 224 136 pregnant women comprising 39 retrospective 23,31,[33][34][35][36][37][38][39][40][42][43][44][47][48][49]51,53,54,56,57,59,61,62,65,67,69,70,73,74,78,79,81,84,85,87,[89][90][91] (n = 157 899) and 24 prospective 30,32,41,45,46,50,52,55,58,60,63,64,66,…”

Lifestyle and pregnancy complications in polycystic ovary syndrome: The SCOPE cohort study

“…Insulin sensitivity decreases over the course of a normal pregnancy. This, in conjunction with pre‐existing IR, may further increase the risk of pregnancy complications in PCOS . The cause of infertility and higher rate of multiple pregnancies following fertility treatment may also contribute to pregnancy complications …”

“…This, in conjunction with pre-existing IR, may further increase the risk of pregnancy complications in PCOS. 21,22 The cause of infertility and higher rate of multiple pregnancies following fertility treatment may also contribute to pregnancy complications. 14,21 Given the short-and long-term health and economic burden of pregnancy complications for both mothers and infants, 23 the assessment of modifiable factors for primary prevention of pregnancy complications is crucial.…”