PCOS ups risks in pregnancy

  • Deborah Condon

Women with polycystic ovary syndrome (PCOS) should be better monitored during pregnancy because they are at an increased risk of suffering pregnancy-related complications, such as pre-eclampsia and premature birth, a new study indicates.

With PCOS, the ovaries tend to be enlarged with multiple cysts on the surface. Symptoms can include irregular periods, hirsutism (excessive growth of body/facial hair) and acne. The condition is estimated to affect one in 10 Irish women.

PCOS can lead to problems with fertility so women with the condition are more likely to undergo fertility treatment.

Swedish researchers decided to investigate the risk of adverse pregnancy outcomes in affected women, which included looking at the effect, if any, of fertility treatment.

They studied almost 4,000 births to women with PCOS and over one million births to women without the condition. They looked at the risk of experiencing an adverse outcome associated with pregnancy, such as pre-eclampsia, gestational diabetes, premature birth, stillbirth and health problems in newborns.

The study found that women with PCOS were 45% more likely to develop pre-eclampsia, a dangerous condition in which a pregnant woman's blood pressure can reach dangerously high levels. Those with PCOS were also at least twice as likely to experience a premature birth and/or to develop gestational diabetes, a type of diabetes that develops only during pregnancy.

The researchers also found that babies born to mothers with PCOS were more likely to be large and were more likely to develop asphyxia (suffocation) during labour.

However, while the results showed that pregnant women with PCOS were more likely to be obese and to have undergone fertility treatment, such as IVF, this did not explain the increase in pregnancy-related risks.

Furthermore, these risks could not be explained by other maternal factors, such as being older when pregnant.
The researchers concluded that these women ‘may need increased surveillance during pregnancy and childbirth'.

Details of these findings are published in the British Medical Journal.

In an accompanying editorial, Prof Nick Macklon, of the University of Southampton said that it was clear that women with PCOS ‘should be considered high risk obstetric patients and that midwives, general practitioners and obstetricians should monitor these women as such'.

For more information on pregnancy, see Irishhealth.com's Pregnancy Clinic here

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