Association between obesity in women with polycystic ovary syndrome and adverse obstetric outcomes

Abstract

Research questionHow does the presence of obesity modify the risks for adverse obstetric outcomes in women with polycystic ovary syndrome (PCOS)? DesignRetrospective population-based cohort study using data from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample, 2004–2014. A total of 14,855 women with PCOS were identified (study group: obese women with PCOS [BMI ≥30 kg/m2] [n = 3286]; reference group: remaining women with PCOS [n =11 569]). Logistic regression analysis was used to explore the associations between obesity, pregnancy, delivery and neonatal outcomes. ResultsObesity was associated with a higher prevalence of chronic hypertension (P < 0.001), pregestational diabetes (P < 0.001) and a previous caesarean delivery (P < 0.001). Obesity increased the risk of gestational diabetes (adjusted [a]OR 1.745; 95% CI 1.473 to 2.067), pregnancy-induced hypertension (aOR1.889; 95% CI 1.589 to 2.246), gestational hypertension (aOR 1.555; 95% CI 1.219 to 1.983) and preeclampsia (aOR 2.170; 95% CI 1.683 to 2.798). Maternal obesity in PCOS increased the risk of chorioamnionitis (aOR 1.548; 95% CI 1.072 to 2.235) and caesarean delivery (aOR 1.414; 95% CI 1.210 to 1.653) and decreased the likelihood of a spontaneous vaginal delivery (aOR 0.751; 95% CI 0.644 to 0.876). Infants born to obese mothers with PCOS were not more likely to be SGA (aOR 0.775; 95% CI 0.511 to 1.175) or to have congenital anomalies (aOR 0.849; 95% CI 0.483 to 1.490). ConclusionIn women with PCOS, obesity increases the risk of specific pregnancy and delivery complications.