Risk of gestational diabetes mellitus in women with polycystic ovary syndrome: a systematic review and a meta-analysis.
OBJECTIVE
To evaluate the risk of gestational diabetes mellitus (GDM) in women with polycystic ovary syndrome (PCOS).


METHODS
Systematic review and meta-analysis of observational studies.


METHODS
Tertiary Department of Reproductive Endocrinology.


METHODS
Five thousand two hundred ninety-three pregnant women (721 with PCOS and 4,572 controls without PCOS).


METHODS
Literature search in the electronic databases MEDLINE, EMBASE, and CENTRAL, study of the references of all relevant trials or reviews, and manual search of the abstracts from the major meetings in the field of human reproduction.


METHODS
Gestational diabetes mellitus odds ratio.


RESULTS
Women with PCOS demonstrated a significantly higher risk for the development of GDM as compared with women without PCOS (odds ratio 2.89, 95% confidence interval [CI] 1.68-4.98), yet with significant statistical heterogeneity (I(2) = 59.3%), durable to sensitivity analysis. In the subgroup of cohort studies, this finding remained robust (7.11, 95% CI 2.95-17.12), whereas in the subgroup of case-control studies, it did not (0.89, 95% CI 0.38-2.06). Metaregression modeling revealed a linear dependence of the outcome on study type and baseline risk (post hoc).


CONCLUSIONS
Significant heterogeneity among studies and dependence of the outcome on study type make the higher risk of GDM in women with PCOS a questionable finding. The conduction of properly designed studies should precede any recommendation to pregnant women with PCOS in regard to the risk of GDM.
Toulis
Konstantinos A
KA
Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Aristotle University, Thessaloniki, Greece. touliskos@gmail.com
Goulis
Dimitrios G
DG
Kolibianakis
Efstratios M
EM
Venetis
Christos A
CA
Tarlatzis
Basil C
BC
Papadimas
Ioannis
I
D015897:Comorbidity; D016640:Diabetes, Gestational / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D011085:Polycystic Ovary Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D011247:Pregnancy; D018570:Risk Assessment; D012307:Risk Factors