Impaired glucose tolerance in pregnant women with polycystic ovary syndrome

Objective: To determine whether women with polycystic ovary syndrome (PCOS) are more likely to develop gestational diabetes mellitus compared with age - and weight-matched controls. Methods: This retrospective cohort study compared reproductive-age women wi th and without PCOS who received prenatal care at the University of North C arolina Hospitals between April 1989 and June 1998. Fie reviewed the medica l charts of 22 women with PCOS diagnosis before pregnancy based on menstrua l histories, elevated androgen levels, and LH-FSH ratios greater than 2. Th ese women were compared with 66 women without PCOS matched for age and weig ht. Gestational diabetes mellitus (GDM) was diagnosed in women if they had abnormal results on a 50-g glucose screening test and at least two abnormal plasma glucose values during a 100-g glucose tolerance test. Medical compl ications of pregnancy, pregnancy complications, and birth outcomes were com pared between women with and without PCOS. Results: Nine of 22 women with PCOS also had GDM diagnosis, compared with t wo of 66 controls (odds ratio [OR] 22.2; 95% confidence interval [CI] 3.8, 170.0), and these women exhibited increased plasma glucose values for all m easurements except fasting. Five of 22 women with PCOS developed preeclamps ia compared with one of 66 controls (OR 15.0; 95% CI 1.9, 121.5). Conclusion: Women with PCOS are at increased risk of glucose intolerance an d preeclampsia during pregnancy. (C) 1999 by The American College of Obstet ricians and Gynecologists.