Higher risk of pregnancy complications in women with polycystic ovary syndrome

Abstract

OBJECTIVE: Previous studies have evaluated pregnancy outcome parameters in small cohorts of women with polycystic ovary syndrome (PCOS). The aim of this study is to assess obstetric and perinatal outcomes in PCOS women. DESIGN: Case control study. MATERIALS AND METHODS: Normogonadotropic anovulatory patients (classification according to the World Health Organization) received a questionnaire. PCOS was diagnosed according to the Rotterdam criteria. Pregnancy outcome parameters of the PCOS women who gave birth between 2000 and 2005 were compared with data from the Netherlands Perinatal Registry (PRN). The PRN contains population based detailed information on pregnancies, deliveries and (re)admissions in the Netherlands registered by midwives, obstetricians and paediatricians. Controls were matched by age, parity, year of delivery and postal code. Outcome parameters were compared between PCOS women and controls using Wilcoxon and Pearson's X2 tests. RESULTS: Questionnaires were sent to 1187 normogonadotropic anovulatory patients, 567 (47,7%) women agreed to participate. PCOS was diagnosed in 497 (88%) women. Of them, 444 (78,3%) patients tried to conceive and 382 women got pregnant at least one time. In total 554 ongoing pregnancies in PCOS women were studied. The singleton pregnancies (n=518) were included in the analysis and compared to 2980 pregnancies in controls. PCOS women showed a significantly higher risk to develop gestational diabetes (p-value < 0.0001), hypertension (p-value < 0.0001) and pre-eclampsia (p-value 0.012). Furthermore, more PCOS women gave birth by unplanned cesarean section (p-value < 0.0001). Finally, their children were more frequently admitted at a neonatal intensive care unit (p-value < 0.0001). CONCLUSION: This large uniform phenotyped cohort study shows that pregnant women with PCOS are at increased risk for obstetric problems and their children for neonatal complications. These risks should be considered during their antenatal, intrapartum and neonatal care.