Lynn Sterling1, Jennifer Liu2, Nan Okun3, Anamika Sakhuja2, Sony Sierra4, Ellen Greenblatt5. 1. Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada. Electronic address: lynn.sterling@utoronto.ca. 2. Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada. 3. Department of Maternal-Fetal Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada. 4. Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada; LifeQuest Centre for Reproductive Medicine, Toronto, Ontario, Canada. 5. Centre for Fertility and Reproductive Health, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
Abstract
OBJECTIVE: To determine whether the diagnosis of polycystic ovary syndrome (PCOS) independently predicts increased rates of pregnancy complications relative to control subjects, after adjusting for important confounders. DESIGN: Retrospective cohort. SETTING: Not applicable. PATIENT(S): A review of all pregnancies after fresh IVF with or without intracytoplasmic sperm injection transfers from December 2006 to 2012 (n = 1,084) identified 394 eligible singleton births (71 women with PCOS; 323 controls without). INTERVENTION(S): Not applicable. MAIN OUTCOME MEASURE(S): Singleton births were assessed for selected adverse pregnancy and birth outcomes. RESULT(S): Women with PCOS demonstrated a higher risk of developing the following pregnancy complications after adjusting for differences in age, parity, body mass index, and time to conception: gestational diabetes (adjusted odds ratio [AOR] 3.15, 95% confidence interval [CI] 1.35-7.33), hypertensive disorders of pregnancy (AOR 4.25, 95% CI 1.94-9.32), preterm birth <37 weeks (AOR 2.30, 95% CI 1.07-4.97), and large for gestational age >90th percentile (AOR 2.77, 95% CI 1.21-6.35). The increased risk of preterm birth <37 weeks was eliminated after adjusting for development of hypertensive disorders of pregnancy, whereas the increased risk of large for gestational age remained significant after adjusting for gestational diabetes mellitus status. Time to conception did not differ significantly between groups, nor did rates of antepartum hemorrhage, cesarean section, or perinatal mortality. CONCLUSION(S): Polycystic ovary syndrome independently predicts higher risk of adverse pregnancy outcomes after adjusting for differences in maternal age, parity, body mass index, and time to conception. This new information may be of relevance in counseling and monitoring women with PCOS, although larger prospective studies may be needed to validate our findings.
OBJECTIVE: To determine whether the diagnosis of polycystic ovary syndrome (PCOS) independently predicts increased rates of pregnancy complications relative to control subjects, after adjusting for important confounders. DESIGN: Retrospective cohort. SETTING: Not applicable. PATIENT(S): A review of all pregnancies after fresh IVF with or without intracytoplasmic sperm injection transfers from December 2006 to 2012 (n = 1,084) identified 394 eligible singleton births (71 women with PCOS; 323 controls without). INTERVENTION(S): Not applicable. MAIN OUTCOME MEASURE(S): Singleton births were assessed for selected adverse pregnancy and birth outcomes. RESULT(S): Women with PCOS demonstrated a higher risk of developing the following pregnancy complications after adjusting for differences in age, parity, body mass index, and time to conception: gestational diabetes (adjusted odds ratio [AOR] 3.15, 95% confidence interval [CI] 1.35-7.33), hypertensive disorders of pregnancy (AOR 4.25, 95% CI 1.94-9.32), preterm birth <37 weeks (AOR 2.30, 95% CI 1.07-4.97), and large for gestational age >90th percentile (AOR 2.77, 95% CI 1.21-6.35). The increased risk of preterm birth <37 weeks was eliminated after adjusting for development of hypertensive disorders of pregnancy, whereas the increased risk of large for gestational age remained significant after adjusting for gestational diabetes mellitus status. Time to conception did not differ significantly between groups, nor did rates of antepartum hemorrhage, cesarean section, or perinatal mortality. CONCLUSION(S): Polycystic ovary syndrome independently predicts higher risk of adverse pregnancy outcomes after adjusting for differences in maternal age, parity, body mass index, and time to conception. This new information may be of relevance in counseling and monitoring women with PCOS, although larger prospective studies may be needed to validate our findings.
Authors: C V Bishop; R L Stouffer; D L Takahashi; E C Mishler; M C Wilcox; O D Slayden; C A True Journal: Hum Reprod Date: 2018-04-01 Impact factor: 6.918