Maternal and neonatal outcomes among pregnant women with different polycystic ovary syndrome phenotypes: A cross-sectional study
Background: Pregnancy is a process associated with various metabolic and hormonal changes, and polycystic ovary syndrome (PCOS) can affect this process.
Objective: This study aimed to evaluate and compare the maternal and neonatal outcomes among pregnant women with different polycystic ovary syndrome phenotypes.
Materials and Methods: In this cross-sectional study, 200 pregnant women with PCOS according to the 2003 ESHRE/ASRM criteria were categorized into four phenotype groups (A-D). The maternal outcomes include gestational diabetes mellitus, pregnancy-induced hypertension, premature rupture of membranes, preterm labor, small-for-gestational age birth, intrauterine growth restriction, intrauterine mortality, preeclampsia, abortion, amniotic fluid disorders, delivery method, and cause of cesarean section were studied between groups. Additionally, neonatal outcomes such as neonatal weight, neonatal recovery, 5-min Apgar score, neonatal icter, the need for NICU admission, the cause of hospitalization, and infant mortality rate were investigated and compared among the groups.
Results: According to the results, phenotype D (37%) was the most common phenotype among the participants. The risk of gestational diabetes was more common in phenotype A than in the other phenotypes, whereas pregnancy-induced hypertension was most common in phenotype B. No significant differences were observed in the neonatal complications among the PCOS phenotypes.
Conclusion: Considering the higher risk of gestational diabetes mellitus and pregnancy-induced hypertension in PCOS phenotypes A and B, women with these phenotypes need more precise prenatal care.
Key words: Pregnancy outcome, Polycystic ovary syndrome, Phenotype, Pregnancy.
 Homburg R. Pregnancy complications in PCOS. Best Practice & Research Clinical Endocrinology & Metabolism 2006; 20: 281–292.
 Ghazeeri GS, Nassar AH, Younes Z, Awwad JT. Pregnancy outcomes and the effect of metformin treatment in women with polycystic ovary syndrome: an overview. Acta Obstet Gynecol Scand 2012; 91: 658–678.
 Carmina E, Lobo RA. Polycystic ovary syndrome (PCOS): arguably the most common endocrinopathy is associated with significant morbidity in women. J Clin Endocrinol Metab 1999; 84: 1897–1899.
 Bruce-Jones W, Zolese G, White P. Polycystic ovary syndrome and psychiatric morbidity. J Psychosom Obstet Gynecol 1993; 14: 111–116.
 Bagegni N, Blaine J, Van Voorhis BJ, Dokras A. Risk of early & late obstetric complications in women with IVF-conceived pregnancies and polycystic ovary syndrome (PCOS). Proceed Obstet Gynecol 2010; 1:1–10.
 Galazis N, Docheva N, Nicolaides KH, Atiomo W. Proteomic biomarkers of preterm birth risk in women with polycystic ovary syndrome (PCOS): a systematic review and biomarker database integration. PloS One 2013; 8: e53801.
 Nikbakht R, Zargar M, Barekati Z, Mohammad Jafari R, Shahbazian N, Barati M. Adverse pregnancy and neonatal outcomes in polycystic ovary syndrome women. Tehran Univ Med J 2016; 73: 827–831.
 Wang JX, Davies MJ, Norman RJ. Polycystic ovarian syndrome and the risk of spontaneous abortion following assisted reproductive technology treatment. Hum Reprod 2001; 16: 2606–2609.
 Elting MW, Korsen TJ, Rekers-Mombarg LT, Schoemaker J. Women with polycystic ovary syndrome gain regular menstrual cycles when ageing. Hum Reprod 2000; 15: 24–28.
 Moran LJ, Norman RJ, Teede HJ. Metabolic risk in PCOS: phenotype and adiposity impact. Trends in Endocrinology and Metabolism 2015; 26: 136–143.
 Vaggopoulos V, Trakakis E, Chrelias C, Panagopoulos P, Basios G, Makridima S, et al. Comparing classic and newer phenotypes in Greek PCOS women: the prevalence of metabolic syndrome and their association with insulin resistance. J Endocrinol Invest 2013; 36: 478–484.
 Baldani DP, Škrgatić L, Goldštajn MS, Vrčić H, Čanić T, Strelec M. Clinical, hormonal and metabolic characteristics of polycystic ovary syndrome among obese and nonobese women in the Croatian population. Coll Antropol 2013; 37: 465–470.
 Winter E, Wang J, Davies MJ, Norman R. Early pregnancy loss following assisted reproductive technology treatment. Hum Reprod 2002; 17: 3220–3223.
 Palomba S, Falbo A, Orio FJr, Zullo F. Effect of preconceptional metformin on abortion risk in polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials. Fertil Steril 2009; 92: 1646–1658.
 Jakubowicz DJ, Iuorno MJ, Jakubowicz S, Roberts KA, Nestler JE. Effects of metformin on early pregnancy loss in the polycystic ovary syndrome. J Clin Endocrinol Metab 2002; 87: 524–529.
 Kollmann M, Klaritsch P, Martins WP, Guenther F, Schneider V, Herzog SA, et al. Maternal and neonatal outcomes in pregnant women with PCOS: comparison of different diagnostic definitions. Hum Reprod 2015; 30: 2396–2403.
 Palomba S, Falbo A, Russo T, Tolino A, Orio F, Zullo F. Pregnancy in women with polycystic ovary syndrome: the effect of different phenotypes and features on obstetric and neonatal outcomes. Fertil Steril 2010; 94: 1805– 1811.
 Roos N, Kieler H, Sahlin L, Ekman-Ordeberg G, Falconer H, Stephansson O. Risk of adverse pregnancy outcomes in women with polycystic ovary syndrome: population based cohort study. BMJ 2011; 343: d6309.
 Qin JZ, Pang LH, Li MJ, Fan XJ, Huang RD, Chen HY. Obstetric complications in women with polycystic ovary syndrome: a systematic review and meta-analysis. Reprod Biol Endocrinol 2013; 11: 56.
 Palomba S, De Wilde MA, Falbo A, Koster MP, La Sala GB, Fauser BC. Pregnancy complications in women with polycystic ovary syndrome. Hum Reprod Update 2015; 21: 575–592.