Risks for Gestational Diabetes Mellitus and Pregnancy-Induced Hypertension Are Increased in Polycystic Ovary Syndrome

Yunhui Wang,Rui Zhang,Huidan Zhao,Jianping Tan,Ricardo Azziz,Xiaomiao Zhao,Hong Ding,Dongzi Yang,Jingte Chen

doi:10.1155/2013/182582

Abstract

Objectives. To evaluate pregnancy outcomes and its determinants in women with polycystic ovary syndrome (PCOS). Methods. Two-hundred and twenty pregnant PCOS and 594 healthy women were followed from early pregnancy. Incidences of gestational diabetes mellitus (GDM), pregnancy-induced hypertension (PIH), preterm birth, twinning, and fetal growth restriction (FGR) were determined. Results. The incidence of GDM was notably higher among all PCOS combined (54.9%; OR: 2.9, 95% CI: 2.0–4.1) and PCOS subgroups, whether they conceived spontaneously (51.5%; OR: 3.3, 95% CI: 2.0–5.4), or via IVF-ET or ovarian stimulation, compared with controls (14.3%; P < 0.001). The incidence of PIH was also higher among all PCOS (10.4%; OR: 2.2, 95% CI: 1.1–4.4) and the subgroup conceiving spontaneously (11.8%; OR: 2.6, 95% CI: 1.1–6.2; P < 0.001) but not for those conceiving with IVF-ET (9.1%) or ovarian stimulation (9.4%). Lean women with PCOS (BMI <24 kg/m2) had higher incidences of GDM (51.1% versus 14.5%; OR: 5.6, 95% CI: 3.4–9.0) and PIH (8.9% versus 3.2%; OR: 3.0, 95% CI: 1.3–7.1) than lean controls. PCOS woemn with normal glucose tolerance had higher risk for PIH than their comparable control group (OR: 4.0, 95% CI: 1.3–11.7). Conclusion. This study suggested that PCOS is an independent risk factor for the development of GDM and PIH. This trial is registered with ChiCTR-RCC-11001824.

Highlights

Polycystic ovary syndrome (PCOS) is a common reproductive-metabolic disorder of women, associated with ovulatory dysfunction, hyperandrogenism, and polycystic ovaries
Metabolic dysfunction may manifest as impaired glucose tolerance or gestational diabetes mellitus (GDM) [3, 4], because pregnancy and its associated high progesterone levels may induce a state of enhanced insulin resistance
We stratified analysis of the incidence of pregnancy outcomes according to conception methods, age at conception (≤30 years or >30 years), BMI (

Summary

Introduction

Polycystic ovary syndrome (PCOS) is a common reproductive-metabolic disorder of women, associated with ovulatory dysfunction, hyperandrogenism, and polycystic ovaries. Metabolic dysfunction may manifest as impaired glucose tolerance or gestational diabetes mellitus (GDM) [3, 4], because pregnancy and its associated high progesterone levels may induce a state of enhanced insulin resistance These women frequently use assisted reproductive techniques (ART) to treat anovulation and infertility and demonstrate polycystic ovaries, which increases their risk of multiple gestations. Women with PCOS have low levels of insulin-like growth factor binding globulin (IGFBP-1), a regulator of IGF-1 activity, which may be associated with fetal growth abnormalities and the development of preeclampsia [5] These morbidities, individually or combined, may affect pregnancy outcomes in these women [6]

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