Increased rates of complications in singleton pregnancies of women previously diagnosed with polycystic ovary syndrome predominantly in the hyperandrogenic phenotype

Marlieke A de Wilde, Marije Lamain-de Ruiter, Susanne M Veltman-Verhulst, Anneke Kwee, Joop S Laven, Cornelis B Lambalk, Marinus J C Eijkemans, Arie Franx, Bart C J M Fauser, Maria P H Koster

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OBJECTIVE: To study the presence of several maternal and neonatal complications in a cohort of women with hyperandrogenic as well as normoandrogenic polycystic ovary syndrome (PCOS) and women with PCOS who received different fertility treatments.

DESIGN: Prospective multicenter cohort study.

SETTING: Hospitals and midwifery practices.

PATIENT(S): One hundred and eighty-eight women with PCOS and singleton pregnancies (study group) and 2,889 women with a naturally conceived singleton pregnancy (reference group).

INTERVENTION(S): Observational study.

MAIN OUTCOME MEASURE(S): Maternal and neonatal pregnancy complications.

RESULT(S): Women with PCOS had a statistically significantly increased risk of developing gestational diabetes (adjusted odds ratio [AOR] 4.15; 95% confidence interval [CI], 2.07-8.33) compared with the reference group, and their infants were more often born small for gestational age (AOR 3.76; 95% CI, 1.69-8.35). In a subgroup analysis, maternal complications were statistically significantly more often present in women with hyperandrogenic (defined as a free androgen index >4.5) PCOS (n = 76; 40% of all PCOS women) compared with those with normoandrogenic PCOS (n = 97; 52% of all PCOS women) (45% vs. 24%; P=.003); no statistically significant differences were observed between these groups regarding neonatal complications.

CONCLUSION(S): Women with PCOS have an increased risk of maternal and neonatal pregnancy complications, especially women with the hyperandrogenic phenotype.


Original languageEnglish
Pages (from-to)333-340
Number of pages8
JournalFertility and Sterility
Issue number2
Publication statusPublished - Aug 2017


  • Adult
  • Causality
  • Comorbidity
  • Female
  • Fertilization in Vitro
  • Humans
  • Hyperandrogenism
  • Incidence
  • Infant, Newborn
  • Infant, Newborn, Diseases
  • Infant, Small for Gestational Age
  • Infertility, Female
  • Journal Article
  • Multicenter Study
  • Netherlands
  • Observational Studies as Topic
  • Polycystic Ovary Syndrome
  • Pregnancy
  • Pregnancy Complications
  • Research Support, Non-U.S. Gov't
  • Risk Factors

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