Pregnancy Complications in Hyperandrogenic PCOS: What Are The Risks?

Women with polycystic ovary syndrome (PCOS) are at significantly increased risk for maternal complications associated with pregnancy, including gestational diabetes, according to research published in Fertility and Sterility.

Marlieke A. de Wilde, MD, PhD, of the department of reproductive medicine and gynecology at the University Medical Center in Utrecht, The Netherlands, and colleauges conducted a prospective multicenter cohort study (Complications of Polycystic Ovary Syndrome Pregnancy: Evaluating Risk [CoPPer]; ClinicalTrials.gov identifier: NCT00821379) to assess maternal complications and pregnancy outcomes in women with PCOS (PCOS group, n=188; reference group, n=2889).

Dr de Wilde and colleagues found that women with PCOS were significantly more likely to experience maternal complications, including gestational diabetes (adjusted odds ratio [aOR]: 4.15; 95% CI, 2.07-8.33) or preterm delivery due to labor induction (aOR: 7.77; 95% CI, 1.81-33.40). Women in this group were also more likely to give birth to infants small for gestational age (aOR: 3.76; 95% CI, 1.69-8.35).

Increased body mass index (BMI) itself was not found to be associated with increased risk of pregnancy complications. Additional subgroup analysis found no statistically significant differences in either maternal or neonatal complications based on method of conception (in vitro fertilization, ovulation induction, or natural conception).

“Most importantly, women with hyperandrogenic PCOS demonstrated a three-fold increased risk of maternal complications compared with the reference group after adjusting for BMI,” the researchers noted. “Women with hyperandrogenic PCOS also exhibited an evidently increased rate of induced preterm delivery and delivery of a[n] SGA [small for gestational age] infant,” concluding that hypoandrogenism may play a role in pregnancy complications.

“Based on our results, we think it may be useful to observe women with PCOS who have a high chance for maternal and neonatal pregnancy complications,” concluded Dr de Wilde and colleauges. “Additional measures taken early during pregnancy may subsequently decrease the occurence of complications in these women.”

Reference

de Wilde MA, Lamain-de Ruiter M, Veltman-Verhulst SM, et al. Increased rates of complications in singleton pregnancies of women previously diagnosed with polycystic ovary syndrom predominantly in the hyperandrogenic phenotype. Fertil Steril. 2017;108(2):333-340. doi:10.1016/j.fertnstert.2017.06.015