title: Maternal and neonatal outcomes in pregnant women with PCOS: comparison of different diagnostic definitions.
abstract: OBJECTIVE
  Does the prevalence of adverse maternal and neonatal outcomes vary in women diagnosed with polycystic ovary syndrome (PCOS) according to different definitions?
  
  
  CONCLUSIONS
  A comparison of different criteria revealed that there is a substantial risk for perinatal complications in PCOS women, regardless of the used definition.
  
  
  BACKGROUND
  Pregnant women with PCOS are susceptible to perinatal complications. At present, there are three main definitions for PCOS. So far, we are aware of only one study, which found that the elevated risk for complications varied widely depending on the different phenotypes and features but only considered a relatively small sample size for some of the phenotypes.
  
  
  METHODS
  Retrospective matched cohort study.
  
  
  METHODS
  Data of primiparous women with PCOS according to ESHRE/ASRM 2003 criteria and healthy controls giving birth to neonates ≥500 g were included. A total of 885 women were analysed: out of 177 women with PCOS, 85 (48.0%) met the National Institutes of Health (NIH) 1990 criteria, another 14 (7.9%) featured the additional phenotypes defined by The Androgen Excess and PCOS Society (AE-PCOS) 2006 criteria, 78 (44.1%) were classified as PCOS exclusively by the ESHRE/ASRM 2003 definition, and 708 represented the control group.
  
  
  RESULTS
  The prevalence of adverse maternal (49.4 versus 64.3 versus 60.3%, P = 0.313) and neonatal (27.1 versus 35.7 versus 23.1%, P = 0.615) outcomes did not differ within the three PCOS groups (ESHRE/ASRM, NIH, AE-PCOS, respectively). Compared with healthy controls, the risk for maternal complications was increased in PCOS patients [odds ratio (OR) 2.57; 95% confidence interval (CI) 1.82-3.64; P < 0.001] while there was no difference in neonatal complications (OR 0.83; 95% CI 0.56-1.21; P = 0.343).
  
  
  CONCLUSIONS
  A limitation of our study is its retrospective design and the relatively small sample size, particularly in the AE-PCOS subgroup.
  
  
  CONCLUSIONS
  Since women with PCOS have, regardless of the used definition, a high risk of maternal and neonatal complications they should be informed and advised to follow regular checks in units where problems can be detected early to allow specialized care.
  
  
  BACKGROUND
  Marietta Blau Grant (Austrian Agency for International Cooperation in Education and Research; OeAD-GmbH) and mobility scholarship (Medical University of Graz).
authors.affiliation: Division of Obstetrics and Maternal Fetal Medicine, Department of Obstetrics and Gynaecology, Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Kollmann
authors.affiliation: Division of Obstetrics and Maternal Fetal Medicine, Department of Obstetrics and Gynaecology, Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria philipp.klaritsch@medunigraz.at.
authors.forename: P
authors.initials: P
authors.lastname: Klaritsch
authors.affiliation: Department of Obstetrics and Gynaecology, Medical School of Ribeirao Preto, University of Sao Paulo, 14048-900 Ribeirao Preto, Brazil.
authors.forename: W P
authors.initials: WP
authors.lastname: Martins
authors.affiliation: Division of Obstetrics and Maternal Fetal Medicine, Department of Obstetrics and Gynaecology, Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria.
authors.forename: F
authors.initials: F
authors.lastname: Guenther
authors.affiliation: Division of Obstetrics and Maternal Fetal Medicine, Department of Obstetrics and Gynaecology, Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria.
authors.forename: V
authors.initials: V
authors.lastname: Schneider
authors.affiliation: Institute for Medical Informatics, Statistics and Documentation (IMI), Medical University of Graz, 8036 Graz, Austria.
authors.forename: S A
authors.initials: SA
authors.lastname: Herzog
authors.affiliation: Division of Child Health, Obstetrics & Gynaecology, School of Medicine, University of Nottingham, NG7 2UH Nottingham, UK.
authors.forename: L
authors.initials: L
authors.lastname: Craciunas
authors.affiliation: Division of Obstetrics and Maternal Fetal Medicine, Department of Obstetrics and Gynaecology, Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria.
authors.forename: U
authors.initials: U
authors.lastname: Lang
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria.
authors.forename: B
authors.initials: B
authors.lastname: Obermayer-Pietsch
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria.
authors.forename: E
authors.initials: E
authors.lastname: Lerchbaum
authors.affiliation: Division of Child Health, Obstetrics & Gynaecology, School of Medicine, University of Nottingham, NG7 2UH Nottingham, UK.
authors.forename: N
authors.initials: N
authors.lastname: Raine-Fenning
mesh_terms: D000328:Adult; D001724:Birth Weight; D015992:Body Mass Index; D001835:Body Weight; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008423:Maternal Age; D016017:Odds Ratio; D010641:Phenotype; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000628:therapy; D011256:Pregnancy Outcome; D047928:Premature Birth; D012189:Retrospective Studies; D018401:Sample Size
keywords: PCOS; complications; phenotypes; polycystic ovary syndrome; pregnancy outcome