Comparing pregnancy, childbirth, and neonatal outcomes in women with different phenotypes of polycystic ovary syndrome and healthy women: a prospective cohort study

Abstract

The aim of this study was to compare pregnancy, childbirth, and neonatal outcomes in women with different phenotypes of polycystic ovary syndrome (PCOS) with healthy women. A prospective cohort study from the beginning to the end of pregnancy for 41 pregnant women with PCOS (case) and 49 healthy pregnant women (control) was completed. Based on the presence or absence of menstrual dysfunction (M), hyperandrogenism (HA), and polycystic ovaries (PCO) on ultrasound, the PCOS (case) group were divided into three phenotypes (HA + PCO (n = 22), M + PCO (n = 9), HA + M+PCO (n = 10). Pre-eclampsia, gestational diabetes, and lower birth weight among newborns were significantly higher in the PCOS case group compared to the control group especially in the phenotype HA + M+PCO (p < .05). High BMI (β = 2.40; p=.03) was the strongest predictor of pre-eclampsia in patients with PCOS. High androgen levels (free androgen index) (β = 13.71, 3.02; p < .05), was the strongest predictor of developing diabetes during pregnancy and reduced birth weight baby, respectively.These results suggest that PCOS, particularly in phenotype HA + M+PCO (p < .05), is a risk factor for adverse pregnancy and neonatal outcomes including gestational diabetes, pre-eclampsia, and reduced weight babies.

摘要

本研究目的是比较不同表型的多囊卵巢综合征（PCOS）妇女与健康妇女的妊娠、分娩和新生儿结局。对41例PCOS孕妇（病例组）和49例健康孕妇（对照组）进行了从妊娠开始到妊娠结束的前瞻性队列研究。比较是否存在月经异常（M）、雄激素过多症（HA）和超声波监测下的多囊卵巢（PCO）, PCOS组（病例组）分为三个表型HA+PCO（n=22）, M+PCO （n=9）, HA+M+PCO（n=10）。与对照组相比, 先兆子痫、妊娠期糖尿病和低出生体重新生儿在PCOS病例组明显升高, 尤其是在表型HA+M+PCO的PCOS组 (p < . 05)。BMI较高（β =2.40；p =.03）是PCOS患者发生先兆子痫的最强预测因子。雄激素水平高（游离雄激素指数）（β =13.71, 3.02；p < .05）分别是预测妊娠期糖尿病和降低婴儿出生体重的最强预测因子。这些结果表明PCOS、尤其是在表型HA+M+PCO（p < . 05）是不良妊娠和新生儿结局（包括妊娠糖尿病、先兆子痫和低出生体重儿）的危险因素。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Polycystic ovary syndrome
• pregnancy complications
• neonatal complications
• phenotype

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The research grant provided by Research Deputy of Kashan University of Medical Science (KUMS).