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Pregnancy complications in PCOS.
1Reproductive Medicine Division, VU University Medical Centre, P.O. Box 7057, 1007MB Amsterdam, The Netherlands. r.homburg@vumc.nl
Summary
Women with Polycystic Ovary Syndrome (PCOS) face higher risks of pregnancy complications like early pregnancy loss and gestational diabetes. Management strategies include pre-pregnancy weight control and metformin, though its use during pregnancy requires further study.
Area of Science:
- Reproductive Endocrinology
- Maternal-Fetal Medicine
- Endocrinology
Background:
- Polycystic Ovary Syndrome (PCOS) is linked to adverse pregnancy outcomes.
- Specific complications include early pregnancy loss (EPL), gestational diabetes (GDM), hypertensive disorders (PET/PIH), and small-for-gestational-age (SGA) infants.
Purpose of the Study:
- To review pregnancy complications associated with maternal PCOS.
- To discuss potential contributing factors and therapeutic options.
Main Methods:
- Literature review and synthesis of existing data on PCOS and pregnancy outcomes.
- Discussion of etiological factors and management strategies.
Main Results:
- PCOS is associated with increased EPL, GDM, PET/PIH, and SGA births.
- Obesity, hyperinsulinemia, elevated LH, and endometrial dysfunction contribute to EPL risk.
- Metformin is a therapeutic option for pre-pregnancy obesity and GDM, but its use in pregnancy is debated.
Conclusions:
- Screening for GDM and PET/PIH in pregnant women with PCOS, especially if obese, is recommended.
- Impaired insulin-mediated growth and fetal programming may explain SGA infants.
- Further large, prospective studies are needed to clarify PCOS-pregnancy associations and optimal management.