PREGNANCY COMPLICATIONS AND OUTCOMES IN WOMEN WITH POLYCYSTIC OVARIAN SYNDROME

Abstract

Background  Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder that has profound implications for women throughout their reproductive years. PCOS is associated with reproductive challenges, including difficulty in conceiving and pregnancy-related complications of miscarriage, hypertensive disorders, gestational diabetes and prematurity, and increased cesarean section(C/S) rate. Objectives  To determine the pregnancy-related complications and outcomes in women with PCOS and to find the risk of these complications in obese and overweight. Patients and Methods Prospective cohort study was conducted in a Maternity teaching hospital and private hospitals and clinics in Sulaymaniyah City Jan. 2018 to Dec. 2021. Involved   313 women with PCOS trying to conceive. PCOS women were diagnosed by having two of the following three criteria, known as Rotterdam criteria (oligo-ovulation or anovulation, clinical or biochemical hyperandrogenism, and polycystic ovaries as seen by ultrasound scan), with the exclusion of other causes of androgen excess and menstrual cycle irregularity or amenorrhoea. They are followed a few months before conception, pregnancy and delivery. Way of conceiving (natural or by induction of ovulation), adverse pregnancy outcomes, and complications like early pregnancy loss, Pregnancy-induced hypertension (PIH), pre-eclampsia (PET), Gestational diabetes mellitus (GDM), preterm delivery, and mode of delivery were recorded. The risk of these complications in obese and overweight compared to normal weight cases was recorded. Results This study included 313 women with PCOS, pregnancy complications were PIH (12.1%), PET (2.2%), GDM (10.5%), pre-term delivery (4.5%), Miscarriage (19.5%), ectopic pregnancy (1.9%), biochemical pregnancy (1.6%), intrauterine fetal death(IUFD) 0.3%, the relation of these complications with pregnancy outcomes showed significant results with p-value of 0.04, 0.02, and 0.01 for PIH, PET, and GDM respectively. These complications were more in obese and overweight PCOS pregnant women than in normal-weight PCOS, but these associations were not significant.  Conclusion Women with PCOS are at increased risk of adverse pregnancy outcomes; pre-pregnancy education, hormonal status regulation, diet and lifestyle changes, and weight loss with better follow-up of these women during pregnancy may decrease these complications. Introducing specific guidelines for pregnant women with PCOS may be beneficial.