Polycystic ovarian syndrome and perinatal outcomes: A population-based pooled cross-sectional study

This study evaluates the associations of preconception polycystic ovarian syndrome (PCOS) and pregnancy conditions (gestational diabetes mellitus (GDM) and gestational hypertension) overall and by maternal obesity and plurality, and the associations of PCOS and birth outcomes overall and by GDM.

We conducted a pooled cross-sectional study using the Pregnancy Risk Assessment Monitoring System (PRAMS) data from 2016 to 2021 for population-based jurisdictions that included PCOS questions (N = 111 417). The PRAMS population-based random sample is weighted to give a representative sample of US women who gave birth in participating jurisdictions. The study exposure, outcomes, and covariates were measured using study questionnaires and birth certificate data. We used logistic regression to estimate confounder-adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Models accounted for sampling weights and were adjusted for maternal demographics and pregnancy characteristics.

Approximately 6.5% (95% CI: 6.38-6.83) of women reported having preconception PCOS. Women with PCOS were more likely to develop GDM (aOR = 1.42; 95% CI = 1.27-1.58), to have gestational hypertension (aOR = 1.38; 95% CI = 1.25-1.52), to undergo cesarean delivery (aOR = 1.14; 95% CI = 1.05-1.24), to deliver a low birthweight infant (aOR = 1.32; 95%, CI = 1.20-1.45), and to have a preterm birth (aOR = 1.25; 95% CI = 1.12-1.39), compared to those without PCOS. Results were consistent across subgroups defined by maternal obesity, plurality, and GDM (as applicable).

Findings fill a gap in research using recent population-based US representative data to emphasize the importance of early detection and tailored management strategies for women with PCOS to mitigate the risks of pregnancy complications and support the need for targeted interventions to improve maternal and neonatal outcomes.