title: Risk of adverse pregnancy outcomes in women with polycystic ovary syndrome: population based cohort study.
abstract: OBJECTIVE
  To study the risk of adverse pregnancy outcomes in women with polycystic ovary syndrome, taking into account maternal characteristics and assisted reproductive technology.
  
  
  METHODS
  Population based cohort study.
  
  
  METHODS
  Singleton births registered in the Swedish medical birth register between 1995 and 2007.
  
  
  METHODS
  By linkage with the Swedish patient register, 3787 births among women with a diagnosis of polycystic ovary syndrome and 1,191,336 births among women without such a diagnosis.
  
  
  METHODS
  Risk of adverse pregnancy outcomes (gestational diabetes, pre-eclampsia, preterm birth, stillbirth, neonatal death, low Apgar score (<7 at five minutes), meconium aspiration, large for gestational age, macrosomia, small for gestational age), adjusted for maternal characteristics (body mass index, age), socioeconomic factors (educational level, and cohabitating with infant's father), and assisted reproductive technology.
  
  
  RESULTS
  Women with polycystic ovary syndrome were more often obese and more commonly used assisted reproductive technology than women without such a diagnosis (60.6% v 34.8% and 13.7% v 1.5%). Polycystic ovary syndrome was strongly associated with pre-eclampsia (adjusted odds ratio 1.45, 95% confidence interval 1.24 to 1.69) and very preterm birth (2.21, 1.69 to 2.90) and the risk of gestational diabetes was more than doubled (2.32, 1.88 to 2.88). Infants born to mothers with polycystic ovary syndrome were more prone to be large for gestational age (1.39, 1.19 to 1.62) and were at increased risk of meconium aspiration (2.02, 1.13 to 3.61) and having a low Apgar score (<7) at five minutes (1.41, 1.09 to 1.83).
  
  
  CONCLUSIONS
  Women with polycystic ovary syndrome are at increased risk of adverse pregnancy and birth outcomes that cannot be explained by assisted reproductive technology. These women may need increased surveillance during pregnancy and parturition.
authors: Department of Women's and Children's Health, Division of Obstetrics and Gynaecology, Karolinska Institutet, Karolinska University Hospital, H2:01, SE-171 76 Stockholm, Sweden. nathalie.roos@karolinska.se
authors: Nathalie
authors: N
authors: Roos
authors: Helle
authors: H
authors: Kieler
authors: Lena
authors: L
authors: Sahlin
authors: Gunvor
authors: G
authors: Ekman-Ordeberg
authors: Henrik
authors: H
authors: Falconer
authors: Olof
authors: O
authors: Stephansson
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001034:Apgar Score; D015992:Body Mass Index; D016640:Diabetes, Gestational / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D008423:Maternal Age; D008471:Meconium Aspiration Syndrome / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology; D011085:Polycystic Ovary Syndrome / Q000453:epidemiology*; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult