Adverse pregnancy outcomes associated with hyperandrogenism in PCOS

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1. Women with PCOS were more likely to have a preterm delivery.

2. Among women with PCOS, those who exhibited hyperandrogenism were more likely to experience preeclampsia and preterm delivery.

Evidence Rating Level: 2 (Good)

Study Rundown: This study found that polycystic ovarian syndrome (PCOS) was associated with adverse pregnancy outcomes. Prior work has shown that pregnant women with PCOS are at increased risk for preeclampsia and preterm delivery, as well as other complications. The present demonstrates that among women with PCOS, those with hyperandrogenism are at increased likelihood for preeclampsia and preterm delivery.

Findings are limited by retrospective design and may be confounded by insulin resistance. Additionally, this PCOS cohort was limited to infertile patients, precluding application of results to the general population. Future studies might include a prospective cohort study and evaluation of women with PCOS who spontaneously conceive.

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Click to read the study in BJOG

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

In-Depth [retrospective cohort study]: This study evaluated the likelihood of adverse pregnancy outcomes in Danish women with PCOS (n=459) as compared to the general population (n=5409). Hyperandrogenism was defined as total testosterone >1.8 nmol/L and/or free testosterone >0.034nmol/L. Outcomes measured included preeclampsia, preterm delivery and small for gestational age infants.

Patients in the PCOS group were more likely to experience preterm delivery <37 weeks gestational age (OR 2.28, CI 1.51-3.45). Among women with PCOS, those with hyperandogenism were more likely to experience preterm delivery (OR 2.78, CI 1.62-4.77) and preeclampsia (OR 2.41, CI 1.26-4.58).

By Denise Pong, MPH and Leah Hawkins, MD, MPH

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