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. 2011 Oct 13:343:d6309.
doi: 10.1136/bmj.d6309.

Risk of adverse pregnancy outcomes in women with polycystic ovary syndrome: population based cohort study

Nathalie Roos  1 , Helle Kieler, Lena Sahlin, Gunvor Ekman-Ordeberg, Henrik Falconer, Olof Stephansson
Affiliations

Risk of adverse pregnancy outcomes in women with polycystic ovary syndrome: population based cohort study

Nathalie Roos et al. BMJ. .

Abstract

Objective: To study the risk of adverse pregnancy outcomes in women with polycystic ovary syndrome, taking into account maternal characteristics and assisted reproductive technology.

Design: Population based cohort study.

Setting: Singleton births registered in the Swedish medical birth register between 1995 and 2007.

Participants: By linkage with the Swedish patient register, 3787 births among women with a diagnosis of polycystic ovary syndrome and 1,191,336 births among women without such a diagnosis.

Main outcome measures: Risk of adverse pregnancy outcomes (gestational diabetes, pre-eclampsia, preterm birth, stillbirth, neonatal death, low Apgar score (<7 at five minutes), meconium aspiration, large for gestational age, macrosomia, small for gestational age), adjusted for maternal characteristics (body mass index, age), socioeconomic factors (educational level, and cohabitating with infant's father), and assisted reproductive technology.

Results: Women with polycystic ovary syndrome were more often obese and more commonly used assisted reproductive technology than women without such a diagnosis (60.6% v 34.8% and 13.7% v 1.5%). Polycystic ovary syndrome was strongly associated with pre-eclampsia (adjusted odds ratio 1.45, 95% confidence interval 1.24 to 1.69) and very preterm birth (2.21, 1.69 to 2.90) and the risk of gestational diabetes was more than doubled (2.32, 1.88 to 2.88). Infants born to mothers with polycystic ovary syndrome were more prone to be large for gestational age (1.39, 1.19 to 1.62) and were at increased risk of meconium aspiration (2.02, 1.13 to 3.61) and having a low Apgar score (<7) at five minutes (1.41, 1.09 to 1.83).

Conclusions: Women with polycystic ovary syndrome are at increased risk of adverse pregnancy and birth outcomes that cannot be explained by assisted reproductive technology. These women may need increased surveillance during pregnancy and parturition.

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Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: that this study received financial support from the Swedish Research Council (projects 73X-20137 (LS) 73X-14612 (GEO)) and the board of postgraduate education at Karolinska Institutet, Stockholm, Sweden (Karolinska Institutet Doctoral Student Financing Funds (KID)) (NR) for the submitted work, and that financial support was also provided through the regional agreement on medical training and clinical research (ALF) between Stockholm County Council and Karolinska Institutet (LS); no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; and no other relationships or activities that could appear to have influenced the submitted work.

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