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Gestational diabetes mellitus risk factors in women with polycystic ovary syndrome (PCOS).

Abstract

OBJECTIVES

To compare the incidence of gestational diabetes mellitus (GDM) in Iranian infertile women with polycystic ovary syndrome (PCOS) and women without PCOS after pregnancies resulting from either assisted reproductive technology (ART) or spontaneous as well as to determine the risk factors of GDM in PCOS women.

STUDY DESIGN

In a cross-sectional study, we evaluated medical records of 234 spontaneous pregnant women without PCOS in Akbarabadi Women's Hospital affiliated to Tehran University of Medical Science, Tehran, Iran, along with 234 pregnant women with PCOS and 234 pregnant non-PCOS women with ART conception who were treated at Royan institute, Tehran, Iran, at the same period of time, 2012 to February 2013. Exclusion criteria were as following: maternal age ≥40, family history of diabetes in first-degree relatives, pre-pregnancy diabetes and history of gestational diabetes, history of stillbirth, recurrent miscarriage, birth weight baby ≥4kg (macrosomia), parity >4, Cushing's syndrome, congenital adrenal hyperplasia and overt hypothyroidism. The GDM diagnosis was according to American Diabetes Association (ADA) criteria. Incidence and the risk factors for GDM were evaluated.

RESULTS

The incidence rates of GDM were 44.4%, 29.9% and 7.3% for PCOS ART, non-PCOS ART and non-PCOS spontaneous pregnant women, respectively. Multivariable logistic regression was used for determining risk factors of GDM in PCOS women with adjusted odds ratios for age, parity and hypothyroidism, the results revealed the most important and significant predictors for development of GDM in PCOS women as follow: menstrual irregularity (OR=4.2; 95% CI=1.7-10.6), serum triglycerides level ≥150mg/dL (OR=1.9; 95% CI=1.07-3.6) and pregestational metformin use (OR=0.4; 95% CI=0.2-0.7).

CONCLUSIONS

Pregnant Iranian women with a history of infertility and PCOS are at increased risk for developing GDM. It is recommendable to perform screening test for GDM in PCOS women with ART treatment, irregular menses and high serum triglycerides level in the early stage of pregnancy. Pregestational use of metformin can be effective in reducing the occurrence of GDM.

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  • Authors+Show Affiliations

    ,

    Department of Endocrinology and Female Infertility at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran; Department of Obstetrics and Gynecology, School of Medicine, Tehran University of Medical Science, Tehran, Iran.

    ,

    Department of Endocrinology and Female Infertility at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.

    ,

    Department of Endocrinology and Female Infertility at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.

    ,

    Department of Endocrinology and Female Infertility at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.

    ,

    Department of Obstetrics and Gynecology, School of Medicine, Tehran University of Medical Science, Tehran, Iran. Electronic address: fereshtenoor@gmail.com.

    Department of Endocrinology and Female Infertility at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.

    Source

    MeSH

    Adult
    Cross-Sectional Studies
    Diabetes, Gestational
    Female
    Fertilization
    Humans
    Hypoglycemic Agents
    Incidence
    Infertility, Female
    Iran
    Menstruation Disturbances
    Metformin
    Polycystic Ovary Syndrome
    Pregnancy
    Reproductive Techniques, Assisted
    Risk Factors
    Triglycerides
    Young Adult

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    25150960

    Citation

    Ashrafi, Mahnaz, et al. "Gestational Diabetes Mellitus Risk Factors in Women With Polycystic Ovary Syndrome (PCOS)." European Journal of Obstetrics, Gynecology, and Reproductive Biology, vol. 181, 2014, pp. 195-9.
    Ashrafi M, Sheikhan F, Arabipoor A, et al. Gestational diabetes mellitus risk factors in women with polycystic ovary syndrome (PCOS). Eur J Obstet Gynecol Reprod Biol. 2014;181:195-9.
    Ashrafi, M., Sheikhan, F., Arabipoor, A., Hosseini, R., Nourbakhsh, F., & Zolfaghari, Z. (2014). Gestational diabetes mellitus risk factors in women with polycystic ovary syndrome (PCOS). European Journal of Obstetrics, Gynecology, and Reproductive Biology, 181, pp. 195-9. doi:10.1016/j.ejogrb.2014.07.043.
    Ashrafi M, et al. Gestational Diabetes Mellitus Risk Factors in Women With Polycystic Ovary Syndrome (PCOS). Eur J Obstet Gynecol Reprod Biol. 2014;181:195-9. PubMed PMID: 25150960.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Gestational diabetes mellitus risk factors in women with polycystic ovary syndrome (PCOS). AU - Ashrafi,Mahnaz, AU - Sheikhan,Fatemeh, AU - Arabipoor,Arezoo, AU - Hosseini,Roya, AU - Nourbakhsh,Fereshteh, AU - Zolfaghari,Zahra, Y1 - 2014/08/07/ PY - 2013/05/19/received PY - 2014/03/05/revised PY - 2014/07/30/accepted PY - 2014/8/25/entrez PY - 2014/8/26/pubmed PY - 2015/6/25/medline KW - Gestational diabetes mellitus KW - Infertility KW - Polycystic ovary syndrome KW - Risk factors SP - 195 EP - 9 JF - European journal of obstetrics, gynecology, and reproductive biology JO - Eur. J. Obstet. Gynecol. Reprod. Biol. VL - 181 N2 - OBJECTIVES: To compare the incidence of gestational diabetes mellitus (GDM) in Iranian infertile women with polycystic ovary syndrome (PCOS) and women without PCOS after pregnancies resulting from either assisted reproductive technology (ART) or spontaneous as well as to determine the risk factors of GDM in PCOS women. STUDY DESIGN: In a cross-sectional study, we evaluated medical records of 234 spontaneous pregnant women without PCOS in Akbarabadi Women's Hospital affiliated to Tehran University of Medical Science, Tehran, Iran, along with 234 pregnant women with PCOS and 234 pregnant non-PCOS women with ART conception who were treated at Royan institute, Tehran, Iran, at the same period of time, 2012 to February 2013. Exclusion criteria were as following: maternal age ≥40, family history of diabetes in first-degree relatives, pre-pregnancy diabetes and history of gestational diabetes, history of stillbirth, recurrent miscarriage, birth weight baby ≥4kg (macrosomia), parity >4, Cushing's syndrome, congenital adrenal hyperplasia and overt hypothyroidism. The GDM diagnosis was according to American Diabetes Association (ADA) criteria. Incidence and the risk factors for GDM were evaluated. RESULTS: The incidence rates of GDM were 44.4%, 29.9% and 7.3% for PCOS ART, non-PCOS ART and non-PCOS spontaneous pregnant women, respectively. Multivariable logistic regression was used for determining risk factors of GDM in PCOS women with adjusted odds ratios for age, parity and hypothyroidism, the results revealed the most important and significant predictors for development of GDM in PCOS women as follow: menstrual irregularity (OR=4.2; 95% CI=1.7-10.6), serum triglycerides level ≥150mg/dL (OR=1.9; 95% CI=1.07-3.6) and pregestational metformin use (OR=0.4; 95% CI=0.2-0.7). CONCLUSIONS: Pregnant Iranian women with a history of infertility and PCOS are at increased risk for developing GDM. It is recommendable to perform screening test for GDM in PCOS women with ART treatment, irregular menses and high serum triglycerides level in the early stage of pregnancy. Pregestational use of metformin can be effective in reducing the occurrence of GDM. SN - 1872-7654 UR - https://www.unboundmedicine.com/medline/citation/25150960/Gestational_diabetes_mellitus_risk_factors_in_women_with_polycystic_ovary_syndrome__PCOS__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0301-2115(14)00415-1 DB - PRIME DP - Unbound Medicine ER -