Gestational Diabetes Mellitus in Women with Polycystic Ovary Syndrome Undergoing Assisted Reproduction

MedPharmRes ◽  
2019 ◽  
Vol 2 (4) ◽  
pp. 26-31
Author(s):  
Chau Tran ◽  
Lan Vuong
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Polycystic Ovary Syndrome ◽  
Gestational Diabetes Mellitus ◽  
Polycystic Ovary ◽  
First Trimester ◽  
Reproductive Age ◽  
Ovary Syndrome ◽  
Logistic Regression Models ◽  
Increased Risk

Polycystic ovary syndrome (PCOS) is a common endocrine metabolic disorder in women of reproductive age. PCOS is often associated with insulin resistance and carries an increased risk of gestational diabetes mellitus (GDM). The aim of this study was to evaluate the risk of GDM in women with a history of PCOS. This was a retrospective cohort study conducted at a single center in Vietnam between January 2014 and December 2017. A total of 400 women who conceived through assisted reproductive technology (ART) were included, 200 who had been diagnosed with PCOS, and 200 without a PCOS diagnosis as controls. Multivariable logistic regression models were used to examine the association between risk of GDM and PCOS after adjusting for confounders. GDM was present in 37% of those with PCOS, compared with 26.5% in those without PCOS (RR 1.4, 95% CI 1.04–1.87, p=0.02). The prevalence of GDM did not differ significantly between PCOS phenotype groups (p=0.28). Women with PCOS undergoing ART had a higher risk of GDM after adjusting for differences in age, pre-pregnancy body mass index, type of infertility, ART indications, and type of ART (adjusted OR 2.04, 95% CI 1.06–3.92). First-trimester fasting plasma glucose (FPG) was also an independent predictor for GDM (adjusted OR 1.54, 95% CI 1.01–2.34). This study suggests that PCOS and first-trimester FPG are independent risk factors for the development of GDM.

scholarly journals Risk Prediction of Gestational Diabetes Mellitus In Women With Polycystic Ovary Syndrome Based On A Nomogram Model

2021 ◽  
Author(s):  
Peilin Ouyang ◽  
You Yiping ◽  
Jia Xiaozhou ◽  
Yang Liqin
Keyword(s):  
Diabetes Mellitus ◽  
Family History ◽  
Gestational Diabetes ◽  
Polycystic Ovary Syndrome ◽  
Gestational Diabetes Mellitus ◽  
Polycystic Ovary ◽  
First Trimester ◽  
Ovary Syndrome ◽  
Family History Of Diabetes ◽  
History Of

Abstract Women with polycystic ovary syndrome are prone to develop gestational diabetes mellitus, a disease which may have significant impact on the postpartum health of both mother and infant. We performed a retrospective cohort study to develop and test a model that could predict gestational diabetes mellitus in the first trimester in women with polycystic ovary syndrome. Our study included 520 pregnant women who were referred to the obstetrics department between December 2017 and March 2020 with a diagnosis of polycystic ovary syndrome. Of these women, 171 were diagnosed with gestational diabetes mellitus in the second trimester. Univariate analysis revealed that in the first trimester, parity, family history of diabetes, age, body mass index (BMI), testosterone, low density lipoprotein cholesterol, triglyceride(TG), total cholesterol(TC), fasting plasma glucose(FPG), Hemoglobin A1c (HbA1C), diastolic blood pressure(DBP)，and insulin levels were predictive factors of gestational diabetes mellitus (P<0.05). Logistic analysis revealed that TG, age, HbA1C, Insulin, TC, BMI and family history of diabetes were independent risk factors for gestational diabetes mellitus. The area under the ROC curve of the gestational diabetes mellitus risk prediction model was 0.917 in this retrospective analysis, demonstrating the great ability to predict. The sensitivity and specificity of the prediction model were 0.814 and 0.871, respectively. The Hosmer–Lemeshow test also showed a good fit to the test.

scholarly journals Metformin Versus Placebo from First Trimester to Delivery in Polycystic Ovary Syndrome: A Randomized, Controlled Multicenter Study

2010 ◽  
Vol 95 (12) ◽  
pp. E448-E455 ◽  
Author(s):  
Eszter Vanky ◽  
Solhild Stridsklev ◽  
Runa Heimstad ◽  
Pål Romundstad ◽  
Kristin Skogøy ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Placebo Group ◽  
Gestational Diabetes ◽  
Polycystic Ovary Syndrome ◽  
Gestational Diabetes Mellitus ◽  
Pregnancy Complications ◽  
Polycystic Ovary ◽  
First Trimester ◽  
Ovary Syndrome ◽  
Metformin Group

Context: Metformin is widely prescribed to pregnant women with polycystic ovary syndrome (PCOS) in an attempt to reduce pregnancy complications. Metformin is not approved for this indication, and evidence for this practice is lacking. Objectives: Our objective was to test the hypothesis that metformin, from first trimester to delivery, reduces pregnancy complications in women with PCOS. Design and Setting: We conducted a randomized, placebo-controlled, double-blind, multicenter study at 11 secondary care centers. Participants: The participants were 257 women with PCOS, in the first trimester of pregnancy, aged 18–42 yr. Intervention: We randomly assigned 274 singleton pregnancies (in 257 women) to receive metformin or placebo, from first trimester to delivery. Main Outcome Measures: The prevalence of preeclampsia, gestational diabetes mellitus, preterm delivery, and a composite of these three outcomes is reported. Results: Preeclampsia prevalence was 7.4% in the metformin group and 3.7% in the placebo group (3.7%; 95% CI, −1.7–9.2) (P = 0.18). Preterm delivery prevalence was 3.7% in the metformin group and 8.2% in the placebo group (−4.4%; 95%, CI, −10.1–1.2) (P = 0.12). Gestational diabetes mellitus prevalence was 17.6% in the metformin group and 16.9% in the placebo group (0.8%; 95% CI, −8.6–10.2) (P = 0.87). The composite primary endpoint prevalence was 25.9 and 24.4%, respectively (1.5%; 95% CI, −8.9–11.3) (P = 0.78). Women in the metformin group gained less weight during pregnancy compared with those in the placebo group. There was no difference in fetal birth weight between the groups. Conclusions: Metformin treatment from first trimester to delivery did not reduce pregnancy complications in PCOS.

scholarly journals Increased risk markers in women with polycystic ovary syndrome and gestational diabetes mellitus during mid-pregnancy

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052093463
Author(s):  
Liqin Zhang ◽  
Lihua Zhang ◽  
Zhangwei Wang ◽  
Lingling Zhu ◽  
Hongxing Wang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Polycystic Ovary Syndrome ◽  
Gestational Diabetes Mellitus ◽  
Cystatin C ◽  
Polycystic Ovary ◽  
Characteristic Curve ◽  
Risk Markers ◽  
Ovary Syndrome ◽  
Increased Risk

Objective This study aimed to investigate application of the urine albumin-to-creatinine ratio (ACR), serum beta 2-microglobulin (β2-MG), and cystatin C as risk markers in a cohort of women with polycystic ovary syndrome (PCOS) for the incidence of gestational diabetes mellitus (GDM). Methods In this cross-sectional study, we analyzed 312 pregnant women with PCOS and classified them as those with and without GDM. For all participants, elbow venous blood and clean middle urine were collected in the morning after 8 hours of an empty stomach. Results Logistic regression analysis showed that the ACR, urine β2-MG levels, and serum cystatin C levels were important markers for women with PCOS concomitant with GDM. Receiver operating characteristic curve analysis showed that the area under the curve of CysC was 0.81 with the threshold based on >0.93 and that of β2-MG was 0.72 with the threshold based on >1.25. Conclusions Increased levels of β2-MG and cystatin C and a high ACR might be risk factors for Chinese women with PCOS and GDM during mid-pregnancy.

scholarly journals Risk for Gestational Diabetes Mellitus and Adverse Birth Outcomes in Chinese Women with Polycystic Ovary Syndrome

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Qing Xiao ◽  
Yong-Yi Cui ◽  
Jine Lu ◽  
Guo-Zheng Zhang ◽  
Fang-Ling Zeng
Keyword(s):  
Diabetes Mellitus ◽  
Preterm Birth ◽  
Gestational Diabetes ◽  
Polycystic Ovary Syndrome ◽  
Gestational Diabetes Mellitus ◽  
Birth Outcomes ◽  
Polycystic Ovary ◽  
Adverse Birth Outcomes ◽  
Ovary Syndrome ◽  
Increased Risk

Objective.To examine the association of polycystic ovary syndrome (PCOS) in early pregnancy with gestational diabetes mellitus (GDM) and adverse birth outcomes.Methods.In this retrospective cohort study including 2389 pregnant women, the medical records of 352 women diagnosed with PCOS were evaluated. Outcomes included GDM, preterm birth, low birth weight, macrosomia, and being small and large for gestational age. Multivariable logistic regression models were used to examine the association of the risk for GDM and adverse birth outcomes with PCOS after adjusting for confounders.Results.Women previously diagnosed with PCOS had a higher risk of GDM (adjusted odds ratio [OR] 1.55, 95% confidence interval [CI]: 1.14–2.09). A strong association was seen between PCOS and preterm birth (adjusted OR 1.69, 95% CI: 1.08–2.67). On stratified analysis, the adjusted OR for GDM among women with PCOS undergoing assisted reproductive technology was 1.44 (95% CI: 1.03–1.92) and among women with PCOS who conceived spontaneously was 1.60 (1.18–2.15). No increased risk for other adverse birth outcomes was observed.Conclusions.Women with PCOS were more likely to experience GDM and preterm birth.

scholarly journals Risks for Gestational Diabetes Mellitus and Pregnancy-Induced Hypertension Are Increased in Polycystic Ovary Syndrome

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Yunhui Wang ◽  
Xiaomiao Zhao ◽  
Huidan Zhao ◽  
Hong Ding ◽  
Jianping Tan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Polycystic Ovary Syndrome ◽  
Gestational Diabetes Mellitus ◽  
Ovarian Stimulation ◽  
Polycystic Ovary ◽  
Pregnancy Induced Hypertension ◽  
Ovary Syndrome ◽  
Induced Hypertension ◽  
Ivf Et

Objectives. To evaluate pregnancy outcomes and its determinants in women with polycystic ovary syndrome (PCOS).Methods. Two-hundred and twenty pregnant PCOS and 594 healthy women were followed from early pregnancy. Incidences of gestational diabetes mellitus (GDM), pregnancy-induced hypertension (PIH), preterm birth, twinning, and fetal growth restriction (FGR) were determined.Results. The incidence of GDM was notably higher among all PCOS combined (54.9%; OR: 2.9, 95% CI: 2.0–4.1) and PCOS subgroups, whether they conceived spontaneously (51.5%; OR: 3.3, 95% CI: 2.0–5.4), or via IVF-ET or ovarian stimulation, compared with controls (14.3%;P<0.001). The incidence of PIH was also higher among all PCOS (10.4%; OR: 2.2, 95% CI: 1.1–4.4) and the subgroup conceiving spontaneously (11.8%; OR: 2.6, 95% CI: 1.1–6.2;P<0.001) but not for those conceiving with IVF-ET (9.1%) or ovarian stimulation (9.4%). Lean women with PCOS (BMI<24kg/m2) had higher incidences of GDM (51.1% versus 14.5%; OR: 5.6, 95% CI: 3.4–9.0) and PIH (8.9% versus 3.2%; OR: 3.0, 95% CI: 1.3–7.1) than lean controls. PCOS woemn with normal glucose tolerance had higher risk for PIH than their comparable control group (OR: 4.0, 95% CI: 1.3–11.7).Conclusion. This study suggested that PCOS is an independent risk factor for the development of GDM and PIH. This trial is registered withChiCTR-RCC-11001824.

scholarly journals Effect of Metformin Intervention during Pregnancy on the Gestational Diabetes Mellitus in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

2014 ◽  
Vol 2014 ◽  
pp. 1-13 ◽  
Author(s):  
Zhihong Zhuo ◽  
Aiming Wang ◽  
Huimin Yu
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Polycystic Ovary Syndrome ◽  
Gestational Diabetes Mellitus ◽  
Polycystic Ovary ◽  
Meta Analysis ◽  
Fixed Effect Model ◽  
Ovary Syndrome ◽  
Insulin Sensitizer ◽  
Functional Consequences

Metformin is an effective insulin sensitizer treating type 2 diabetes mellitus. However, the functional consequences of metformin administration throughout pregnancy on gestational diabetes mellitus (GDM) with polycystic ovary syndrome (PCOS) have not been assessed. We therefore performed a meta-analysis and system review to determine the effect of metformin on GDM in PCOS. A meta-analysis was performed on the published studies before December, 2013. Meta-analysis examined whether metformin could reduce GDM occurrence in PCOS with a fixed effect model. The odds ratio (OR) with 95% confidence interval (95% CI) was calculated to estimate the strength of association. A total of 13 studies including 5 RCTs and 8 non-RCTs were enrolled. Ultimately, effectiveness analysis demonstrated that, in total, there was no significant availability of metformin on GDM in PCOS in contrast to placebo (OR = 1.07, 95% CI 0.60–1.92) in RCTs and significant availability of metformin on GDM (OR = 0.19, 95% CI 0.13–0.27) was indicated in non-RCTs. In summary, according to the results of our meta-analysis, strictly, metformin did not significantly effect on GDM with PCOS, though more multicenters RCTs still need to be investigated.

scholarly journals The risk factors of gestational diabetes mellitus in patients with polycystic ovary syndrome

Medicine ◽  
2021 ◽  
Vol 100 (31) ◽  
pp. e26521
Author(s):  
Xiaocui Li ◽  
Xinru Liu ◽  
Yan Zuo ◽  
Jiejun Gao ◽  
Yan Liu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Gestational Diabetes ◽  
Polycystic Ovary Syndrome ◽  
Gestational Diabetes Mellitus ◽  
Polycystic Ovary ◽  
Ovary Syndrome
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