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Risk of adverse pregnancy outcomes in women with polycystic ovary syndrome: population based cohort study.
BMJ 2011; 343:d6309BMJ

Abstract

OBJECTIVE

To study the risk of adverse pregnancy outcomes in women with polycystic ovary syndrome, taking into account maternal characteristics and assisted reproductive technology.

DESIGN

Population based cohort study.

SETTING

Singleton births registered in the Swedish medical birth register between 1995 and 2007.

PARTICIPANTS

By linkage with the Swedish patient register, 3787 births among women with a diagnosis of polycystic ovary syndrome and 1,191,336 births among women without such a diagnosis.

MAIN OUTCOME MEASURES

Risk of adverse pregnancy outcomes (gestational diabetes, pre-eclampsia, preterm birth, stillbirth, neonatal death, low Apgar score (<7 at five minutes), meconium aspiration, large for gestational age, macrosomia, small for gestational age), adjusted for maternal characteristics (body mass index, age), socioeconomic factors (educational level, and cohabitating with infant's father), and assisted reproductive technology.

RESULTS

Women with polycystic ovary syndrome were more often obese and more commonly used assisted reproductive technology than women without such a diagnosis (60.6% v 34.8% and 13.7% v 1.5%). Polycystic ovary syndrome was strongly associated with pre-eclampsia (adjusted odds ratio 1.45, 95% confidence interval 1.24 to 1.69) and very preterm birth (2.21, 1.69 to 2.90) and the risk of gestational diabetes was more than doubled (2.32, 1.88 to 2.88). Infants born to mothers with polycystic ovary syndrome were more prone to be large for gestational age (1.39, 1.19 to 1.62) and were at increased risk of meconium aspiration (2.02, 1.13 to 3.61) and having a low Apgar score (<7) at five minutes (1.41, 1.09 to 1.83).

CONCLUSIONS

Women with polycystic ovary syndrome are at increased risk of adverse pregnancy and birth outcomes that cannot be explained by assisted reproductive technology. These women may need increased surveillance during pregnancy and parturition.

Authors+Show Affiliations

Department of Women's and Children's Health, Division of Obstetrics and Gynaecology, Karolinska Institutet, Karolinska University Hospital, H2:01, SE-171 76 Stockholm, Sweden. nathalie.roos@karolinska.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21998337

Citation

Roos, Nathalie, et al. "Risk of Adverse Pregnancy Outcomes in Women With Polycystic Ovary Syndrome: Population Based Cohort Study." BMJ (Clinical Research Ed.), vol. 343, 2011, pp. d6309.
Roos N, Kieler H, Sahlin L, et al. Risk of adverse pregnancy outcomes in women with polycystic ovary syndrome: population based cohort study. BMJ. 2011;343:d6309.
Roos, N., Kieler, H., Sahlin, L., Ekman-Ordeberg, G., Falconer, H., & Stephansson, O. (2011). Risk of adverse pregnancy outcomes in women with polycystic ovary syndrome: population based cohort study. BMJ (Clinical Research Ed.), 343, pp. d6309. doi:10.1136/bmj.d6309.
Roos N, et al. Risk of Adverse Pregnancy Outcomes in Women With Polycystic Ovary Syndrome: Population Based Cohort Study. BMJ. 2011 Oct 13;343:d6309. PubMed PMID: 21998337.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk of adverse pregnancy outcomes in women with polycystic ovary syndrome: population based cohort study. AU - Roos,Nathalie, AU - Kieler,Helle, AU - Sahlin,Lena, AU - Ekman-Ordeberg,Gunvor, AU - Falconer,Henrik, AU - Stephansson,Olof, Y1 - 2011/10/13/ PY - 2011/10/15/entrez PY - 2011/10/15/pubmed PY - 2011/12/13/medline SP - d6309 EP - d6309 JF - BMJ (Clinical research ed.) JO - BMJ VL - 343 N2 - OBJECTIVE: To study the risk of adverse pregnancy outcomes in women with polycystic ovary syndrome, taking into account maternal characteristics and assisted reproductive technology. DESIGN: Population based cohort study. SETTING: Singleton births registered in the Swedish medical birth register between 1995 and 2007. PARTICIPANTS: By linkage with the Swedish patient register, 3787 births among women with a diagnosis of polycystic ovary syndrome and 1,191,336 births among women without such a diagnosis. MAIN OUTCOME MEASURES: Risk of adverse pregnancy outcomes (gestational diabetes, pre-eclampsia, preterm birth, stillbirth, neonatal death, low Apgar score (<7 at five minutes), meconium aspiration, large for gestational age, macrosomia, small for gestational age), adjusted for maternal characteristics (body mass index, age), socioeconomic factors (educational level, and cohabitating with infant's father), and assisted reproductive technology. RESULTS: Women with polycystic ovary syndrome were more often obese and more commonly used assisted reproductive technology than women without such a diagnosis (60.6% v 34.8% and 13.7% v 1.5%). Polycystic ovary syndrome was strongly associated with pre-eclampsia (adjusted odds ratio 1.45, 95% confidence interval 1.24 to 1.69) and very preterm birth (2.21, 1.69 to 2.90) and the risk of gestational diabetes was more than doubled (2.32, 1.88 to 2.88). Infants born to mothers with polycystic ovary syndrome were more prone to be large for gestational age (1.39, 1.19 to 1.62) and were at increased risk of meconium aspiration (2.02, 1.13 to 3.61) and having a low Apgar score (<7) at five minutes (1.41, 1.09 to 1.83). CONCLUSIONS: Women with polycystic ovary syndrome are at increased risk of adverse pregnancy and birth outcomes that cannot be explained by assisted reproductive technology. These women may need increased surveillance during pregnancy and parturition. SN - 1756-1833 UR - https://www.unboundmedicine.com/medline/citation/21998337/Risk_of_adverse_pregnancy_outcomes_in_women_with_polycystic_ovary_syndrome:_population_based_cohort_study_ L2 - http://www.bmj.com/cgi/pmidlookup?view=long&amp;pmid=21998337 DB - PRIME DP - Unbound Medicine ER -