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Meta-Analysis
. 2016 Dec;95(51):e4863.
doi: 10.1097/MD.0000000000004863.

Association between polycystic ovary syndrome and the risk of pregnancy complications: A PRISMA-compliant systematic review and meta-analysis

Hai-Feng Yu  1 , Hong-Su Chen, Da-Pang Rao, Jian Gong
Affiliations
Meta-Analysis

Association between polycystic ovary syndrome and the risk of pregnancy complications: A PRISMA-compliant systematic review and meta-analysis

Hai-Feng Yu et al. Medicine (Baltimore). 2016 Dec.

Abstract

Background: Polycystic ovary syndrome (PCOS) is inconsistently associated with increased risk of adverse pregnancy outcomes. The purpose of this meta-analysis was to summarize the evidence regarding the strength of the association between pregnancy in women with PCOS and pregnancy complications.

Methods: We systematically searched PubMed, EmBase, and the Cochrane Library to identify observational studies up to January 2016. The primary focus was pregnancy outcomes, including gestational diabetes mellitus (GDM), preeclampsia, pregnancy-induced hypertension (PIH), preterm delivery, cesarean delivery, oligohydramnios, and polyhydramnios. Effect estimates were pooled using the random-effects model. The analysis was further stratified by factors that could affect these associations.

Results: We included 40 observational studies that reported data on a total of 17,816 pregnancies with PCOS and 123,756 pregnancies without PCOS. Overall, PCOS in pregnancy was associated with greater risk of GDM, preeclampsia, PIH, preterm delivery, cesarean delivery, miscarriage, hypoglycemia, and perinatal death. However, PCOS in pregnancy had little or no effect on oligohydramnios, polyhydramnios, large-for-gestational age (LGA), small-for-gestational-age (SGA), fetal growth restriction (FGR), preterm premature membrane rupture, fasting blood glucose (FBG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride, total cholesterol, congenital malformation, macrosomia, and respiratory distress syndrome. Subgroup analysis suggested that these associations might be influenced by study design and pre-BMI.

Conclusion: PCOS in pregnancy is associated with a significantly increased risk of adverse pregnancy, fetal, and neonatal outcomes.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flow diagram of the literature search and trials selection process.
Figure 2
Figure 2
Association between PCOS in pregnancy and the risk of GDM (A), preeclampsia (B), and PIH (C). GDM = gestational diabetes mellitus, PCOS = polycystic ovary syndrome, PIH = pregnancy-induced hypertension.
Figure 3
Figure 3
Association between polycystic ovary syndrome (PCOS) in pregnancy and the risk of preterm delivery (A), cesarean delivery (B), or oligohydramnios and polyhydramnios (C).
Figure 4
Figure 4
Association between PCOS in pregnancy and the risk of LGA, SGA, FGR, preterm premature rupture of membrane, and miscarriage. FGR = fetal growth restriction, LGA = large-for-gestational age, PCOS = polycystic ovary syndrome, SGA = small-for-gestational-age.
Figure 5
Figure 5
Association between PCOS in pregnancy and the levels of FBG, HDL, LDL, triglyceride, and total cholesterol. FBG = fasting blood glucose, HDL = high density lipoprotein, LDL = low density lipoprotein, PCOS = polycystic ovary syndrome.
Figure 6
Figure 6
Association between polycystic ovary syndrome (PCOS) in pregnancy and the risk of hypoglycemia, perinatal death, pregnancy and congenital malformation, macrosomia, and respiratory distress syndrome.
See this image and copyright information in PMC

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