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Gestational diabetes and neonatal macrosomia in the polycystic ovary syndrome
J Wortsman1, S de Angeles, W Futterweit
1Department of Medicine, Southern Illinois University, Springfield 62794-9230.
Insights
Polycystic Ovary Syndrome (PCOS) patients do not face increased risks for gestational diabetes or neonatal macrosomia during pregnancy. This study found similar incidences of these conditions in PCOS pregnancies compared to controls.
Area of Science:
- Reproductive Endocrinology
- Maternal-Fetal Medicine
- Metabolic Disorders
Background:
- Polycystic Ovary Syndrome (PCOS) is frequently associated with insulin resistance, even with normal glucose tolerance.
- Pregnancy imposes a diabetogenic effect, necessitating evaluation of glucose tolerance in PCOS patients during gestation.
Purpose of the Study:
- To assess glucose tolerance in pregnant patients with Polycystic Ovary Syndrome (PCOS).
- To compare the incidence of gestational diabetes and neonatal macrosomia in PCOS pregnancies versus a general pregnant population.
Main Methods:
- Retrospective analysis of clinical data from 53 PCOS patients across two centers.
- Comparison with a control group of 2,306 consecutive pregnancies.
- Evaluation of gestational diabetes incidence and neonatal macrosomia rates (birth weight > 4,000 g).
Main Results:
- The incidence of gestational diabetes in PCOS patients was 7.5%, statistically similar to the 6.6% in controls.
- Neonatal macrosomia occurred in 7% of infants born to PCOS women, comparable to control groups (12.4% normal glucose tolerance, 14.5% gestational diabetes).
Conclusions:
- Preexisting Polycystic Ovary Syndrome (PCOS) does not appear to elevate the risk of developing gestational diabetes.
- PCOS is not associated with an increased risk of neonatal macrosomia in pregnancy.
Abstract:
Since patients with polycystic ovary syndrome (PCOS) commonly have insulin resistance, albeit with normal glucose tolerance, we evaluated glucose tolerance in PCOS patients exposed to the diabetogenic effect of pregnancy. The clinical material was obtained from two centers, in Springfield, Illinois (22 patients), and New York, New York (31 patients), and the results were compared with a control population with 2,306 consecutive general pregnancies. There were no differences between PCOS patients from the two centers in regard to age or ponderal index (P greater than .1). A review of the medical records showed that the incidence of gestational diabetes in the PCOS patients was 7.5%, similar (P greater than .1) to the 6.6% frequency of gestational diabetes in the controls. The overall incidence of neonatal macrosomia (birth weight greater than 4,000 g) was 7% (4 of 57) among infants born to PCOS women. That was similar to the 12.4% incidence of neonatal macrosomia among infants born to women with normal glucose tolerance and to the 14.5% incidence among infants born to women with gestational diabetes. Preexisting PCOS does not appear to increase the risk of developing gestational diabetes or neonatal macrosomia.