With the high level of medical care available in the Los Angeles area, many Angeleno women with polycystic ovary syndrome (PCOS) are able to achieve a pregnancy. However, PCOS has been linked to pregnancy complications, including increased risks for gestational diabetes, hypertensive disease during pregnancy, and premature birth. Adding to the evidence is a large study, published in the British Medical Journal on October 13; it reported that women with PCOS are at increased risk for pregnancy complications, whether or not they have undergone fertility treatments. Researchers at the Department of Women’s and Children’s Health, Karolinska University (Stockholm, Sweden) conducted a large study of women both with and without PCOS. “Available studies are, however, limited in size and have mainly included women undergoing assisted reproductive technology (ART),” wrote Nathalie Roos, MD and colleagues. “Consequently the extent to which the risk of adverse pregnancy outcomes in women with PCOS is attributed to the underlying disorder or infertility treatment is uncertain.”
To further determine how those factors are interrelated, the researchers evaluated pregnancy complications and outcomes in Swedish women who had given birth from 1995 to 2007. The study group included 3,787 births among women with PCOS and 1,191,336 births among women without PCOS. The researchers assessed risks for various pregnancy outcomes, including preeclampsia, gestational diabetes, premature birth, stillbirth, poor neonatal health, and neonatal death. They also factored in the women’s demographic and clinical characteristics, such as age, body mass index (BMI), socioeconomic status, and whether they had undergone fertility treatments.
The researchers noted: “In the present population based study a diagnosis of polycystic ovary syndrome was associated with increased risks of adverse pregnancy outcomes that could not be attributed to the increased use of assisted reproductive technology or maternal characteristics such as advanced age or being overweight or obese.” However, the women with PCOS were more often obese (60.6% vs. 34.8%) and more commonly used ART (13.7% vs. 1.5%) than women without PCOS. PCOS was also strongly associated with preeclampsia (1.45 times higher) and very premature birth (2.21 times higher). Risks for gestational diabetes more than doubled in women with PCOS (2.32 times higher). Furthermore, infants of mothers with PCOS were more often large for gestational age (1.39 times higher) and were at elevated risk for meconium aspiration (2.02 times higher). They were also more likely to have low Apgar scores (less than 7) at 5 minutes (1.41 times higher).
The authors concluded: “These women may need increased surveillance during pregnancy and parturition. Future research would benefit from focusing on glucose control, medical treatment, and hormonal status among women with polycystic ovary syndrome during pregnancy.”
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