PCOS Tied to Higher Risk of Adverse Birth Outcomes: Meta-Analysis Reveals Insights

Polycystic Ovary Syndrome (PCOS): Impact on Pregnancy Outcomes | The Lifesciences Magazine


Polycystic ovary syndrome (PCOS) affects approximately 13% of women in their reproductive years, often leading to anovulatory infertility and necessitating fertility treatments. Beyond fertility challenges, women with PCOS face increased risks of health disorders like hypertension, obesity, and depression. These conditions contribute to poorer birth outcomes in their offspring, as highlighted by recent meta-analyses.

Studies have consistently shown that women with Polycystic ovary syndrome experience higher rates of adverse birth outcomes compared to those without the syndrome. These outcomes include increased perinatal mortality, higher rates of neonatal intensive care unit (NICU) admissions, lower mean birth weights, and elevated incidences of preterm birth. However, gaps remain in understanding weight-related indices and the specific maternal characteristics influencing these outcomes.

About the Polycystic Ovary Syndrome Study

The latest meta-analysis and systematic review, encompassing data up to July 2022, aimed to provide updated insights into the association between PCOS and pregnancy outcomes. Researchers examined 73 studies involving 77,811 offspring from women without PCOS and 15,070 offspring from women with PCOS. Only studies meeting strict inclusion criteria, such as using the Rotterdam criteria for PCOS diagnosis and excluding those based solely on self-reported data or the International Classification of Diseases (ICD), were considered.

Utilizing random-effects meta-analyses, the study generated pooled effect estimates to evaluate various pregnancy outcomes linked with PCOS. This rigorous approach ensured robust findings, despite challenges like varying definitions of outcome variables across studies.

Study Findings and Conclusions

The findings underscored significant differences in birth outcomes between women with and without Polycystic ovary syndrome. Women with PCOS tended to be younger and had higher gestational weight gain and body mass index (BMI), factors that consistently correlated with adverse outcomes such as preterm birth and lower mean birth weights.

Specifically, the odds of preterm birth were notably higher among women with PCOS across all analyses, including sensitivity checks. Similarly, lower mean birth weights were observed consistently among infants born to mothers with PCOS, although these findings did not extend uniformly to pregnancies involving assisted reproductive technology (ART) or gestational diabetes mellitus (GDM).

Regarding fetal growth, women with PCOS faced increased odds of fetal growth restriction, although this association varied across different sub-group analyses. Notably, no significant differences were found in the odds of small or large gestational age between women with and without PCOS.

The study’s conclusions emphasized the need for tailored healthcare strategies for women with PCOS during pregnancy, considering their elevated risks. Factors like ART, BMI, and maternal age should be carefully managed to mitigate adverse outcomes. However, the study acknowledged limitations, including inconsistencies in defining risk factors and insufficient data for certain sub-groups like pregnancies with GDM or those involving ART.

In essence, while confirming the heightened risks associated with Polycystic ovary syndrome in pregnancy, the meta-analysis highlighted areas for further research and clinical refinement to optimize maternal and neonatal health outcomes in affected populations.

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