Maternal and Neonatal Outcomes for Pregnancies Complicated by Type 2 Diabetes and Polycystic Ovary Syndrome

Our aim in this study was to determine the prevalence of polycystic ovary syndrome (PCOS) among pregnancies affected by type 2 diabetes (T2D) and explore its relationship with maternal and neonatal outcomes.

Pregnancies affected by T2D from the Calgary Diabetes in Pregnancy program from 2008 to 2020 were chart reviewed for presence of PCOS, using logistic regression to examine associations between PCOS and maternal and neonatal outcomes.

The prevalence of PCOS in pregnancies affected by T2D was 134 of 897 (14.9%). Compared with pregnancies affected by T2D alone, pregnancies affected by PCOS and T2D had higher odds of nulliparity (odds ratio [OR] 2.09, 95% confidence interval [CI] 1.44 to 3.02), prepregnancy weight ≥91 kg (OR 1.79, 95% CI 1.23, 2.60), preconception care (OR 2.79, 95% CI 1.77 to 4.40), and metformin use (OR 2.01, 95% CI 1.37 to 2.93). They also had lower odds of maternal age ≥35 years (OR 0.68, 95% CI 0.46 to 0.99), singleton pregnancy (OR 0.29, 95% CI 0.11 to 0.75), and insulin use (OR 0.60, 95% CI 0.39 to 0.93). There were no statistically significant differences between groups for neonatal outcomes.

The prevalence of PCOS among our cohort of pregnant women with T2D was lower than the reported prevalence of PCOS among women with T2D, perhaps reflecting the subfertility PCOS can confer. This may also explain the association with PCOS and nulliparity. People with PCOS were also more likely to receive preconception care and metformin treatment.