Increased rates of complications in singleton pregnancies of women previously diagnosed with polycystic ovary syndrome predominantly in the hyperandrogenic phenotype

Fertil Steril. 2017 Aug;108(2):333-340. doi: 10.1016/j.fertnstert.2017.06.015.


Objective: To study the presence of several maternal and neonatal complications in a cohort of women with hyperandrogenic as well as normoandrogenic polycystic ovary syndrome (PCOS) and women with PCOS who received different fertility treatments.

Design: Prospective multicenter cohort study.

Setting: Hospitals and midwifery practices.

Patient(s): One hundred and eighty-eight women with PCOS and singleton pregnancies (study group) and 2,889 women with a naturally conceived singleton pregnancy (reference group).

Intervention(s): Observational study.

Main outcome measure(s): Maternal and neonatal pregnancy complications.

Result(s): Women with PCOS had a statistically significantly increased risk of developing gestational diabetes (adjusted odds ratio [AOR] 4.15; 95% confidence interval [CI], 2.07-8.33) compared with the reference group, and their infants were more often born small for gestational age (AOR 3.76; 95% CI, 1.69-8.35). In a subgroup analysis, maternal complications were statistically significantly more often present in women with hyperandrogenic (defined as a free androgen index >4.5) PCOS (n = 76; 40% of all PCOS women) compared with those with normoandrogenic PCOS (n = 97; 52% of all PCOS women) (45% vs. 24%; P=.003); no statistically significant differences were observed between these groups regarding neonatal complications.

Conclusion(s): Women with PCOS have an increased risk of maternal and neonatal pregnancy complications, especially women with the hyperandrogenic phenotype.

Clinical trial registration number: NCT00821379.

Keywords: Hyperandrogenic; PCOS; pregnancy complications.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Causality
  • Comorbidity
  • Female
  • Fertilization in Vitro / statistics & numerical data
  • Humans
  • Hyperandrogenism / epidemiology*
  • Incidence
  • Infant, Newborn
  • Infant, Newborn, Diseases / epidemiology*
  • Infant, Small for Gestational Age
  • Infertility, Female / epidemiology*
  • Infertility, Female / therapy*
  • Netherlands / epidemiology
  • Observational Studies as Topic
  • Polycystic Ovary Syndrome / epidemiology*
  • Pregnancy
  • Pregnancy Complications / epidemiology*
  • Risk Factors

Associated data