Obstetric outcome in women with polycystic ovarian syndrome

• Published in: Human reproduction (Oxford) Vol. 16; no. 2; pp. 226 - 229
• Main Authors: Mikola, M., Hiilesmaa, V., Halttunen, M., Suhonen, L., Tiitinen, A.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.02.2001; Oxford Publishing Limited (England)
• Subjects: Adult; Biological and medical sciences; Case-Control Studies; Diabetes, Gestational - complications; Diseases of mother, fetus and pregnancy; Female; Female genital diseases; gestational diabetes mellitus; Gynecology. Andrology. Obstetrics; Humans; Infant, Newborn; Insulin Resistance; Medical sciences; Obstetric Labor, Premature - complications; polycystic ovary syndrome; Polycystic Ovary Syndrome - complications; pre-eclampsia; Pre-Eclampsia - complications; Pregnancy; Pregnancy Complications - physiopathology; Pregnancy Outcome; Pregnancy, Multiple; Pregnancy. Fetus. Placenta; Risk Factors; Tumors; pre-eclampsia; gestational diabetes mellitus; pregnancy; polycystic ovary syndrome; Endocrinopathy; Human; Pancreatic hormone; Prognosis; Pregnancy disorders; Diabetes mellitus; Female sterility; Polycystic ovary; Maternal diseases; Insulin; Pregnancy toxemia; Female genital diseases; Pregnancy; Ovarian diseases; Body mass index; Target tissue resistance; Preeclampsia; Cyst; Risk factor; Female; Benign neoplasm
• ISSN: 0268-1161; 1460-2350; 1460-2350
• DOI: 10.1093/humrep/16.2.226

Women with polycystic ovarian syndrome (PCOS) often have insulin resistance and hyperinsulinaemia and may therefore be at an increased risk for gestational diabetes mellitus (GDM). Hyperinsulinaemia may also be associated with pre-eclampsia. Information concerning outcome of pregnancies in PCOS women is scanty and somewhat controversial. Therefore, 99 pregnancies were retrospectively evaluated in women with PCOS and the findings were compared with an unselected control population. The average body mass index (BMI) in PCOS patients was greater than that in controls (25.6 versus 23.0) (P < 0.0001), and PCOS patients were more often nulliparous than controls (76 versus 42%) (P < 0.001). The multiple pregnancy rate was 9.1% in PCOS patients and 1.1% in controls [odds ratio (OR) 9.0; 95% confidence interval (CI) 3.5–23.3]. GDM developed in 20% of the PCOS patients and in 8.9% of the controls (P < 0.001). After logistic regression analysis, BMI >25 seemed to be the greatest predictor for GDM (adjusted OR 5.1; CI 3.2–8.3), while PCOS remained as another independent predictor (adjusted OR 1.9; CI 1.0–3.5). In contrast, PCOS was not a significant predictor for pre-eclampsia, which was merely associated with nulliparity. Premature delivery (16.1% in PCOS and 6.5% in controls) was explained to a large extent by multiple pregnancies and marginally by nulliparity and PCOS. In singleton pregnancies, there was no difference in birth weights, Apgar scores or perinatal morbidity of infants. In conclusion, PCOS slightly increases the risk for GDM, but does not have an important effect on the rate of premature delivery and pre-eclampsia.