Fetal-maternal outcomes and complications in pregnant women with polycystic ovary syndrome.
BACKGROUND
Earlier studies have shown that polycystic ovary syndrome (PCOS) is associated with cardiovascular disease as well as pregnancy complications. We examined whether women with PCOS have an increased risk of complications in pregnancy compared with healthy women, and if there are any correlations between complications and clinical/demographic variables before and/or in early pregnancy.


METHODS
This retrospective cohort study comprised 37 women with PCOS and 126 healthy women whose birth was recorded at Sundsvall County Hospital, Sweden, from 2009 to 2014. Medical records were searched to identify pregnancy complications, maternal outcomes, and neonatal outcomes.


RESULTS
Compared with healthy women, the women with PCOS were more likely to have a history of miscarriage (42.9% vs. 19.8% P=0.005) and undergo caesarean section (41.2% vs. 21.4%, P=0.019). They were also at increased risk of developing a complication (odds ratio 2.38, 95% CI: 1.05-5.38) or having multiple concurrent complications (odds ratio 8.27, 95% CI: 1.45-47.3). The rates of premature birth, birth weight and Apgar score at 5 min were similar between the two groups. The preconception serum testosterone concentration was positively correlated with the complication rate and negatively correlated with gestational age.


CONCLUSIONS
We found that women with PCOS are at greater risk of complications during pregnancy than healthy women, consistent with the results of earlier studies. High testosterone concentrations could be an aggravating factor in the risk of complications. Therefore, women with PCOS may require more careful monitoring during pregnancy than healthy women.
Department of Clinical Sciences, Obstetrics and Gynecology, Sundsvalls Research Unit, Umeå University, Umeå, Sweden.
Charlotta
C
Klevedal
Department of Clinical Sciences, Obstetrics and Gynecology, Sundsvalls Research Unit, Umeå University, Umeå, Sweden - sahruh.turkmen@umu.se.
Sahruh
S
Turkmen
D000328:Adult; D001034:Apgar Score; D001724:Birth Weight; D016022:Case-Control Studies; D002585:Cesarean Section / Q000706:statistics & numerical data; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013548:Sweden; D013739:Testosterone / Q000097:blood*; D055815:Young Adult
D013739:Testosterone