title: Pregnancy outcomes in women with polycystic ovary syndrome undergoing in vitro fertilization.
abstract: OBJECTIVE
  To determine whether the diagnosis of polycystic ovary syndrome (PCOS) independently predicts increased rates of pregnancy complications relative to control subjects, after adjusting for important confounders.
  
  
  METHODS
  Retrospective cohort.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  A review of all pregnancies after fresh IVF with or without intracytoplasmic sperm injection transfers from December 2006 to 2012 (n = 1,084) identified 394 eligible singleton births (71 women with PCOS; 323 controls without).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Singleton births were assessed for selected adverse pregnancy and birth outcomes.
  
  
  RESULTS
  Women with PCOS demonstrated a higher risk of developing the following pregnancy complications after adjusting for differences in age, parity, body mass index, and time to conception: gestational diabetes (adjusted odds ratio [AOR] 3.15, 95% confidence interval [CI] 1.35-7.33), hypertensive disorders of pregnancy (AOR 4.25, 95% CI 1.94-9.32), preterm birth <37 weeks (AOR 2.30, 95% CI 1.07-4.97), and large for gestational age >90th percentile (AOR 2.77, 95% CI 1.21-6.35). The increased risk of preterm birth <37 weeks was eliminated after adjusting for development of hypertensive disorders of pregnancy, whereas the increased risk of large for gestational age remained significant after adjusting for gestational diabetes mellitus status. Time to conception did not differ significantly between groups, nor did rates of antepartum hemorrhage, cesarean section, or perinatal mortality.
  
  
  CONCLUSIONS
  Polycystic ovary syndrome independently predicts higher risk of adverse pregnancy outcomes after adjusting for differences in maternal age, parity, body mass index, and time to conception. This new information may be of relevance in counseling and monitoring women with PCOS, although larger prospective studies may be needed to validate our findings.
authors.affiliation: Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada. Electronic address: lynn.sterling@utoronto.ca.
authors.forename: Lynn
authors.initials: L
authors.lastname: Sterling
authors.affiliation: Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Maternal-Fetal Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.
authors.forename: Nan
authors.initials: N
authors.lastname: Okun
authors.affiliation: Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Anamika
authors.initials: A
authors.lastname: Sakhuja
authors.affiliation: Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada; LifeQuest Centre for Reproductive Medicine, Toronto, Ontario, Canada.
authors.forename: Sony
authors.initials: S
authors.lastname: Sierra
authors.affiliation: Centre for Fertility and Reproductive Health, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Ellen
authors.initials: E
authors.lastname: Greenblatt
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D005260:Female; D005298:Fertility; D005307:Fertilization in Vitro / Q000009:adverse effects; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D050498:Live Birth; D016015:Logistic Models; D015999:Multivariate Analysis; D016017:Odds Ratio; D011085:Polycystic Ovary Syndrome / Q000150:complications* / Q000175:diagnosis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology; D018873:Pregnancy Rate; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Diabetes (gestational); hypertension (pregnancy-induced); in vitro fertilization; polycystic ovary syndrome; pregnancy outcomes