Risk Factors for Gestational Diabetes in Women with Polycystic Ovarian Syndrome

Abstract

We aimed to compare the pre-gestational metabolic states of the women who were previously diagnosed with policystic ovarian syndrome and had gestational diabetes mellitus in the subsequent pregnancy and who did not have gestational diabetes mellitus in subsequent pregnancy and to determine the independent variables that predict the gestational diabetes mellitus risk for policystic ovarian syndrome patients in the subsequent pregnancy. Between the dates 2007 and 2012, the patients who were diagnosed with policystic ovarian syndrome in our outpatient gynecology clinic were searched retrospectively. Then these patients were called for pregnancy states. All of these patients have pregnancy spontaneously. The patients’ pre-gestational mean age, body mass index, metabolic and hormonal profiles and pregnancy outcomes were compared between policystic ovarian syndrome cases who developed gestational diabetes mellitus or not. We found some differences in pregestational metabolic states between the policystic ovarian syndrome patients who developed gestational diabetes mellitus in pregnancy or not. The mean age, body mass index, very low density lipoprotein, triglyceride, fasting insulin, fasting c-peptide levels, 1st and 2nd hour glucose levels in 75 gr oral glucose tolerance test, homeostatsis model assessment –insulin resistance measures and neonates’ birth weights were higher in gestational diabetes mellitus group than non-gestational diabetes mellitus group. But high density lipoprotein was lower in gestational diabetes mellitus group than non- gestational diabetes mellitus group. There were no differences between the mean levels C- reactive protein, hormonal profile, mean fasting glucose, low density lipoprotein cholesterol, total cholesterol levels and mode of delivery. Glucose intolerance was significantly higher in the gestational diabetes mellitus group (%74,07 vs %6,66). With the multipl logistic regression analysis we found the body mass index as the strongest independent predictor of gestational diabetes mellitus in policystic ovarian syndrome patients (OR: 2,831, %95 CI: 1,234-6,495). The second independent predictor was the high 2nd hour glucose level in oral glucose tolerance test(OR: 1,119, %95 CI: 1,026-1,221). The pre-gestational metabolic variables including the age, body mass index, lipid profile, and glucose metabolism are significantly different in the gestational diabetes mellitus group than the non-gestational diabetes mellitus group. The obesity and glucose intolerance are the independent predictors of gestational diabetes mellitus in policystic ovarian syndrome cases.