Obstetric outcome in women with polycystic ovarian syndrome

Women with polycystic ovarian syndrome (PCOS) often have insulin resistance and hyperinsulinaemia and may therefore be at an increased risk for gestat ional diabetes mellitus (GDM). Hyperinsulinaemia may also be associated wit h pre-eclampsia, Information concerning outcome of pregnancies in PCOS wome n is scanty and somewhat controversial. Therefore, 99 pregnancies were retr ospectively evaluated in women with PCOS and the findings were compared wit h an unselected control population. The average body mass index (BMI) in PC OS patients was greater than that in controls (25.6 versus 23.0) (P < 0.000 1), and PCOS patients were more often nulliparous than controls (76 versus 42%) (P < 0.001). The multiple pregnancy rate was 9.1% in PCOS patients and 1.1% in controls [odds ratio (OR) 9.0; 95% confidence interval (CI) 3.5-23 .3]. GDM developed in 20% of the PCOS patients and in 8.9% of the controls (P < 0.001). After logistic regression analysis, BMI >25 seemed to be the g reatest predictor for GDM (adjusted OR 5.1; CI 3.2-8.3), while PCOS remaine d as another independent predictor (adjusted OR 1.9; CI 1.0-3.5). In contra st, PCOS was not a significant predictor for pre-eclampsia, which was merel y associated with nulliparity. Premature delivery (16.1% in PCOS and 6.5% i n controls) was explained to a large extent by multiple pregnancies and mar ginally by nulliparity and PCOS. In singleton pregnancies, there was no dif ference in birth weights, Apgar scores or perinatal morbidity of infants. I n conclusion, PCOS slightly increases the risk for GDM, but does not have a n important effect on the rate of premature delivery and pre-eclampsia.