Increased maternal pregnancy complications in polycystic ovary syndrome appear to be independent of obesity—A systematic review, meta-analysis, and meta-regression

Mahnaz Bahri Khomami, Anju E. Joham, Jacqueline A. Boyle, Terhi Piltonen, Michael Silagy, Chavy Arora, Marie L. Misso, Helena J. Teede, Lisa J. Moran

Research output: Contribution to journalReview ArticleResearchpeer-review

Abstract

Polycystic ovary syndrome (PCOS) is associated with an increased risk of maternal pregnancy and delivery complications. However, the impact of clinical features of PCOS and other potential risk factors in PCOS is still unknown. We aimed to investigate the association of PCOS with maternal pregnancy and delivery complications with consideration of risk factors and potential confounders. The meta-analysis included 63 studies. PCOS was associated with higher miscarriage, gestational diabetes mellitus, gestational hypertension, pre-eclampsia, induction of labour, and caesarean section. The association of PCOS with these outcomes varied by geographic continent, PCOS phenotypes, and study quality. Pre-eclampsia and induction of labour were not associated with PCOS on body mass index-matched studies. No outcome was associated with PCOS on assisted pregnancies. Age was significantly associated with higher miscarriage on meta-regression. There were no studies assessing perinatal depression. We confirm that PCOS is associated with an increased risk of maternal pregnancy and delivery complications. The association of PCOS with the outcomes is worsened in hyperandrogenic PCOS phenotypes, in specific geographic continents, and in the highest quality studies but disappears in assisted pregnancies. Future studies in PCOS are warranted to investigate proper timing for screening and prevention of maternal pregnancy and delivery complications with consideration of clinical features of PCOS.

Original languageEnglish
Pages (from-to)659-674
Number of pages16
JournalObesity Reviews
Volume20
Issue number5
DOIs
Publication statusPublished - 1 May 2019

Keywords

  • gestational diabetes mellitus
  • gestational hypertension
  • miscarriage
  • obesity
  • polycystic ovary syndrome
  • pregnancy

Cite this

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title = "Increased maternal pregnancy complications in polycystic ovary syndrome appear to be independent of obesity—A systematic review, meta-analysis, and meta-regression",
abstract = "Polycystic ovary syndrome (PCOS) is associated with an increased risk of maternal pregnancy and delivery complications. However, the impact of clinical features of PCOS and other potential risk factors in PCOS is still unknown. We aimed to investigate the association of PCOS with maternal pregnancy and delivery complications with consideration of risk factors and potential confounders. The meta-analysis included 63 studies. PCOS was associated with higher miscarriage, gestational diabetes mellitus, gestational hypertension, pre-eclampsia, induction of labour, and caesarean section. The association of PCOS with these outcomes varied by geographic continent, PCOS phenotypes, and study quality. Pre-eclampsia and induction of labour were not associated with PCOS on body mass index-matched studies. No outcome was associated with PCOS on assisted pregnancies. Age was significantly associated with higher miscarriage on meta-regression. There were no studies assessing perinatal depression. We confirm that PCOS is associated with an increased risk of maternal pregnancy and delivery complications. The association of PCOS with the outcomes is worsened in hyperandrogenic PCOS phenotypes, in specific geographic continents, and in the highest quality studies but disappears in assisted pregnancies. Future studies in PCOS are warranted to investigate proper timing for screening and prevention of maternal pregnancy and delivery complications with consideration of clinical features of PCOS.",
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Increased maternal pregnancy complications in polycystic ovary syndrome appear to be independent of obesity—A systematic review, meta-analysis, and meta-regression. / Bahri Khomami, Mahnaz; Joham, Anju E.; Boyle, Jacqueline A.; Piltonen, Terhi; Silagy, Michael; Arora, Chavy; Misso, Marie L.; Teede, Helena J.; Moran, Lisa J.

In: Obesity Reviews, Vol. 20, No. 5, 01.05.2019, p. 659-674.

Research output: Contribution to journalReview ArticleResearchpeer-review

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T1 - Increased maternal pregnancy complications in polycystic ovary syndrome appear to be independent of obesity—A systematic review, meta-analysis, and meta-regression

AU - Bahri Khomami, Mahnaz

AU - Joham, Anju E.

AU - Boyle, Jacqueline A.

AU - Piltonen, Terhi

AU - Silagy, Michael

AU - Arora, Chavy

AU - Misso, Marie L.

AU - Teede, Helena J.

AU - Moran, Lisa J.

PY - 2019/5/1

Y1 - 2019/5/1

N2 - Polycystic ovary syndrome (PCOS) is associated with an increased risk of maternal pregnancy and delivery complications. However, the impact of clinical features of PCOS and other potential risk factors in PCOS is still unknown. We aimed to investigate the association of PCOS with maternal pregnancy and delivery complications with consideration of risk factors and potential confounders. The meta-analysis included 63 studies. PCOS was associated with higher miscarriage, gestational diabetes mellitus, gestational hypertension, pre-eclampsia, induction of labour, and caesarean section. The association of PCOS with these outcomes varied by geographic continent, PCOS phenotypes, and study quality. Pre-eclampsia and induction of labour were not associated with PCOS on body mass index-matched studies. No outcome was associated with PCOS on assisted pregnancies. Age was significantly associated with higher miscarriage on meta-regression. There were no studies assessing perinatal depression. We confirm that PCOS is associated with an increased risk of maternal pregnancy and delivery complications. The association of PCOS with the outcomes is worsened in hyperandrogenic PCOS phenotypes, in specific geographic continents, and in the highest quality studies but disappears in assisted pregnancies. Future studies in PCOS are warranted to investigate proper timing for screening and prevention of maternal pregnancy and delivery complications with consideration of clinical features of PCOS.

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