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Review
. 2019 Nov 1;104(11):5299-5315.
doi: 10.1210/jc.2019-00383.

A Narrative Review of Placental Contribution to Adverse Pregnancy Outcomes in Women With Polycystic Ovary Syndrome

Angela S Kelley  1 , Yolanda R Smith  1 , Vasantha Padmanabhan  1   2
Affiliations
Review

A Narrative Review of Placental Contribution to Adverse Pregnancy Outcomes in Women With Polycystic Ovary Syndrome

Angela S Kelley et al. J Clin Endocrinol Metab. .

Abstract

Context: Polycystic ovary syndrome (PCOS) is the most common endocrinopathy of reproductive-aged women. In pregnancy, women with PCOS experience increased risk of miscarriage, gestational diabetes, preeclampsia, and extremes of fetal birth weight, and their offspring are predisposed to reproductive and cardiometabolic dysfunction in adulthood. Pregnancy complications, adverse fetal outcomes, and developmental programming of long-term health risks are known to have placental origins. These findings highlight the plausibility of placental compromise in pregnancies of women with PCOS.

Evidence synthesis: A comprehensive PubMed search was performed using terms "polycystic ovary syndrome," "placenta," "developmental programming," "hyperandrogenism," "androgen excess," "insulin resistance," "hyperinsulinemia," "pregnancy," and "pregnancy complications" in both human and animal experimental models.

Conclusions: There is limited human placental research specific to pregnancy of women with PCOS. Gestational androgen excess and insulin resistance are two clinical hallmarks of PCOS that may contribute to placental dysfunction and underlie the higher rates of maternal-fetal complications observed in pregnancies of women with PCOS. Additional research is needed to prevent adverse maternal and developmental outcomes in women with PCOS and their offspring.

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Figures

Figure 1.
Figure 1.
Placental dysfunction mediated by androgen excess and insulin resistance may lead to adverse pregnancy, birth, and long-term developmental outcomes in offspring.
Figure 2.
Figure 2.
Proposed mechanisms for placental dysfunction in women with PCOS.
Figure 3.
Figure 3.
Future directions in the field of PCOS placental research. Images used were sourced from open-source resources: www.pixabay.com, www.kisspng.com, www.wikipedia.org, and www.openclipart.org.
See this image and copyright information in PMC

References

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