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Adverse Pregnancy Outcomes in Patients with Polycystic Ovary Syndrome with Pre-Conceptional Hyperandrogenism: A Multi-Institutional Registry-Based Retrospective Cohort Study

Year: 2024

Type: article

Abstract: Background/Objectives: Women with polycystic ovarian syndrome (PCOS) are at higher risk for pregnancy complications. The PCOS population is heterogeneous, with different phenotypes linked to varying risks of adverse outcomes. However, literature on pre-conceptional hyperandrogenism is limited and based on small sample sizes. Methods: This multi-institutional registry-based retrospective cohort study included pregnant patients diagnosed with PCOS with or without pre-conceptional hyperandrogenism. Utilizing the TriNetX platform, one-to-one propensity score matching was conducted to adjust for confounding factors. Exclusion criteria included multiple pregnancies and patients who received assisted reproductive technology, oral contraceptives, or spironolactone. 571 patients with PCOS and pre-conceptional hyperandrogenism and 13,465 patients with PCOS without hyperandrogenism were identified. Post-propensity matching, each cohort consisted of 564 patients. Results: Pregnant women diagnosed with PCOS and pre-conceptional hyperandrogenism showed a higher risk of large for gestational age (6.6% vs. 3.9%, OR = 1.73, 95% CI [1.007–2.972], p-value = 0.045) and preterm birth (10.3% vs. 5.9%, OR = 1.844, 95% CI [1.183–2.876], p-value = 0.006), but had no significant increase in the risk of gestational hypertension, preeclampsia/eclampsia, gestational diabetes, missed abortion, intrauterine growth restriction, placenta abruption, or cesarean section. Conclusions: Women with PCOS and pre-conceptional hyperandrogenism have an increased risk of pregnancy complications, especially large for gestational age and preterm birth. Further research is needed to clarify the underlying mechanisms, and whether treatment can improve outcomes.

Source: Journal of Clinical Medicine

DOI: 10.3390/jcm14010123

Authors: Yi-Ting Chang, Ming-Jer Chen, Wei-Szu Lin, Ching-Heng Lin, Jui-Chun Chang

Institutions: Taichung Veterans General Hospital, National Yang Ming Chiao Tung University, Fu Jen Catholic University, Tunghai University

Language: English

Topic: Ovarian function and disorders

Subfield: Reproductive Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,955