In women with polycystic ovary syndrome (PCOS) there is convincing evidence that preconception hyperandrogenism and impaired glucose tolerance are predictive of multiple obstetric and perinatal complications that may affect both maternal and child outcomes, according to study findings published in the Journal of Clinical Endocrinology & Metabolism.

PCOS is the most common endocrine disorder affecting women of childbearing age, putting them at increased risk for complications during pregnancy and the perinatal period. In this study, researchers aimed to identify which subset of women with PCOS faced the highest risk for obstetric and/or neonatal complications. The cohort was drawn from 2 large studies and included 2768 women diagnosed with PCOS before conception. Data was subsequently linked to the Dutch Perinatal registry. A total of 1715 women were included in the analysis, and of these participants, 98% had oligo-anovulation, 95% had polycystic ovarian morphology, and 50% had hyperandrogenism.

The study findings showed that prepregnancy free androgen index was associated with subsequent preeclampsia (odds ratio [OR], 1.1; 95% CI, 1.0-1.1; P =.02), while fasting glucose (OR, 1.4; 95% CI, 1.2-1.7; P =.001) and testosterone (OR, 1.5; 95% CI, 1.2-1.7; P =.001) levels were predictive of preterm delivery. Any adverse obstetric and perinatal outcome was independently predicted by the presence of a multiple gestation pregnancy (OR, 5.9; 95% CI, 3.6-9.8; P <.001), white ethnicity (OR, 0.5; 95% CI, 04-0.7; P <.001), smoking status (OR, 1.7; 95% CI, 1.2-2.3; P =.002), testosterone (OR, 1.2; 95% CI, 1.1-1.4; P =.002), and fasting insulin (OR, 1.003; 95% CI, 1.001-1.005; P =.013).

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“The current results suggest that primary disease characteristics of PCOS, chiefly hyperandrogenism and changes in blood glucose regulation have relevance in predicting obstetric complications among PCOS women,” concluded the researchers.

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Christ JP, Gunning MN, Meun C, et al. Pre-conception characteristics predict obstetrical and neonatal outcomes in women with polycystic ovary syndrome [published online December 24, 2018]. J Clin Endocrinol Metab. doi:10.1210/jc.2018-01787