Fetomaternal Outcome in Women With Gestational Diabetes Mellitus With and Without Polycystic Ovary Syndrome: A Comparative Approach

TL;DR

This study compares pregnancy outcomes in women with gestational diabetes and polycystic ovary syndrome versus those with gestational diabetes alone, finding no significant differences in complications.

Contribution

The study provides new evidence that PCOS does not worsen pregnancy outcomes in women with gestational diabetes.

Findings

Women with GDM and PCOS did not experience worse maternal or fetal outcomes compared to those with GDM alone.

Differences in maternal weight gain and family diabetes history were observed but did not affect overall outcomes.

The presence of PCOS alongside GDM did not increase the risk of adverse pregnancy complications.

Abstract

Background

Gestational diabetes mellitus (GDM) is an increasing health concern during pregnancy, associated with various maternal and fetal complications, such as pre-eclampsia, polyhydramnios, fetal macrosomia, birth trauma, neonatal metabolic complications, and prenatal death. Polycystic ovary syndrome (PCOS) is characterized by symptoms like amenorrhea, oligomenorrhea, hirsutism, obesity, infertility, anovulation, and acne. This paper compares the fetomaternal outcomes in patients with both PCOS and GDM and those with GDM alone.

Aim

The aim of this paper is to compare the fetomaternal outcomes in patients with both PCOS and GDM with those having GDM alone. By identifying differences in outcomes, the study could help develop guidelines for early interventions and precautionary measures for women with PCOS before conception. This approach could reduce pregnancy complications and mitigate long-term metabolic risks for both the mother and the child. Furthermore, the paper emphasizes the need to develop predictive algorithms based on risk factors to prevent adverse outcomes for both mothers and neonates.

Materials and methods

This prospective cohort study included 88 singleton pregnancies with a known diagnosis of GDM, including those with PCOS diagnosed according to the Rotterdam criteria. Participants were women aged 18 years and older, with a gestational age between 5 and 40 weeks. The participants were divided into two groups: GDM with PCOS (Group A) and GDM without PCOS (Group B). At the first visit, patients were initially screened using the DIPSI criteria, which involves a non-fasting 75g glucose challenge test. Patients with a two-hour plasma glucose level of 140 mg/dL or above were identified as positive. Subsequently, these patients underwent a standard oral glucose tolerance test for further evaluation and confirmation of glucose intolerance. Women were followed until delivery. Various parameters were studied, including Doppler changes, polyhydramnios/oligohydramnios, gestational age, mode of delivery, onset of labor (spontaneous/induced), fetal growth restriction or macrosomia, shoulder dystocia, and puerperal complications such as postpartum hemorrhage, lactation failure, and breast abscess. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 20 (Released 2011; IBM Corp., Armonk, New York, United States). Continuous variables were expressed as mean ± SD, and categorical variables were represented as percentages. A two-sided P-value of less than 0.05 was considered statistically significant.

Conclusion

The study concluded that the patients in the GDM with PCOS group did not have poorer fetomaternal outcomes compared to those with GDM alone. Therefore, while certain factors like maternal weight gain and family history of diabetes differed between the groups, the presence of PCOS alongside GDM did not result in worse outcomes for either the mother or the neonate in this cohort.