New research published on bmj.com this week claims that women with polycystic ovary syndrome (POS) are more likely to have problems with pregnancy even if they are undergoing fertility treatment.
Approximately 5 to 15% of women who are of reproductive age suffer from polycystic ovary syndrome, a common disorder in which small cysts typically develop around the edge of the ovaries. The symptoms consist of irregular periods, ovulation problems, weight gain and excessive hair growth, with those affected by the condition being more likely to seek fertility treatment.
The Swedish researchers urge for better monitoring of women suffering from polycystic ovary syndrome during pregnancy and childbirth as they are at a greater risk of giving birth prematurely, develop diabetes and pre-eclampsia. Researchers previously believed, that these outcomes were explained by assisted reproductive technology although this is not the case.
Researchers from the Karolinska Institutet and Karolinska University Hospital in Stockholm, Sweden decided to examine the risk of adverse pregnancy outcomes in women with polycystic ovary syndrome. They accounted for maternal characteristics and fertility treatment.
The researchers evaluated nationwide data, which included information on 3,787 births amongst women suffering from polycystic ovary syndrome and 1,191,336 births of women without the condition by measuring the risk of adverse pregnancy outcomes, including pregnancy-induced diabetes, pre-eclampsia, premature birth, still-, and neonatal death as well as poor health in newborns.
Adjustments were made for variables, such as maternal characteristics, including age and body mass index, socioeconomic factors and fertility treatment such as IVF.
The findings revealed, that women diagnosed with polycystic ovary syndrome were more often obese and more often used assisted reproductive technology, such as IVF treatment compared to women without the condition.
The researchers discovered a strong association between polycystic ovary syndrome (POS) and pre-eclampsia. Women with POS had a 45% higher risk of developing pre-eclampsia and were more than twice as likely to give birth prematurely and/or to develop pregnancy induced diabetes.
They also discovered that babies whose mothers suffered from POS had a greater likelihood of being large at their gestational age and tended to develop asphyxia during labor.
In summary, the study revealed that a diagnosis of polycystic ovary syndrome was linked to increased risks of adverse pregnancy outcomes and that increased use of assisted reproductive technology or maternal characteristics, such as advanced age or being overweight or obese did not attribute to the outcomes.
In a concluding statement the researchers say:
“These women may need increased surveillance during pregnancy and childbirth. Future research would benefit from focusing on glucose control, medical treatment and hormonal status among women with polycystic ovary syndrome during pregnancy.”
Professor Nick Macklon from the University of Southampton writes in an accompanying editorial, “It is clear that women with polycystic ovary syndrome should be considered “high risk” obstetric patients and that midwives, general practitioners, and obstetricians should monitor these women as such.”
However, in his opinion:
“more evidence is required to support the use of currently used interventions designed to reduce perinatal risk, and this requires a greater understanding of the different polycystic ovary syndrome phenotypes and the underlying mechanisms by which this common condition alters pregnancy outcomes.”
Written by Petra Rattue