Healthy pregnant women with and without polycystic ovary syndrome experience similar rates of adverse obstetric outcomes, likely due to women with PCOS following a healthier lifestyle, according to findings published in Clinical Endocrinology.
In a multicenter analysis of pregnant women across four countries, researchers also found that women with PCOS had a 38% lower risk for delivering a baby large for gestational age than women without PCOS.
“These findings highlight that following a healthy lifestyle may compensate for the risk of having PCOS for pregnancy complications,” Lisa J. Moran, PhD, associate professor at the School of Public Health and Preventive Medicine at Monash University in Melbourne, Australia, and colleagues wrote. “Thus, risk estimation for pregnancy outcomes could be similarly performed in women with and without PCOS, providing they have a similar health or lifestyle profile.”
In a prospective study, Moran and colleagues analyzed data from 5,628 healthy nulliparous women with singleton pregnancies participating in the Screening for Pregnancy Endpoints (SCOPE) study, a multicenter study of low-risk women from Australia, Ireland, New Zealand and the United Kingdom. Women were recruited between November 2004 and February 2011. Researchers followed women until delivery for pregnancy outcomes and newborn measurements, collecting ongoing pregnancy data, including dietary information, low-dose multivitamin supplementation and exercise activity. PCOS status was self-reported. Gestational diabetes analyses were conducted in women living in Australia and New Zealand.
Within the cohort, 354 women (6.3%) had PCOS. Women with PCOS tended to be older and have a higher BMI and were more likely to be taking multivitamins, exercising regularly, earning a higher income and more likely to have received fertility treatments. Among women with PCOS, 26 were taking metformin during the first trimester, according to researchers.
Of 2,078 women screened for gestational diabetes, crude prevalence was higher among women with PCOS compared with women without PCOS (9.7% vs. 4.7%; OR = 2.2; 95% CI, 1.2-4). However, the proportions of gestational hypertension (7.3% vs. 8.4%), preeclampsia (5.9% vs. 6.7%) and mean difference of early gestational weight gain (2.3 kg vs. 2.5 kg) were similar among women with and without PCOS, respectively. Similarly, researchers observed no between-group differences in crude models for infant birth weight (mean, 3,388 g vs. 3,401 g), prevalence of babies born small for gestational age (10.2% vs. 11.4%) or spontaneous preterm birth (5.7% vs. 4.1%) among infants born to mothers with PCOS vs. without PCOS, respectively.
In multivariable models, early gestational weight gain and infant birth weight were similar among women with and without PCOS. Researchers also observed a reduced risk for babies born large for gestational age among women with PCOS vs. women without PCOS (OR = 0.62; 95% CI, 0.4-0.98).
“As overweight and obesity and diabetes mellitus are elevated in PCOS ... it may be expected that PCOS would be associated with a greater prevalence of [large for gestational age] babies,” the researchers wrote. “The reason for these disparate findings is unclear but may be related to the overall healthier profile in women with PCOS.”
The findings suggest that the beneficial effects of lifestyle modification on PCOS may extend to improved pregnancy outcomes, the researchers wrote; however, the findings must be confirmed by assessing pregnancy complications in women with well-defined PCOS and controls. – by Regina Schaffer
Disclosures: The authors report no relevant financial disclosures.