Endocrine Abstracts

PREGNANCY OUTCOMES IN POLYCYSTIC OVARY SYNDROME

Garg S1,2, Brady J1, Ivison F2, Sief MW1 and Laing I2.

Department of Obstetrics and Gynaecology, Manchester University, at St Mary's Hospital1, and Department of Clinical Biochemistry, Manchester Royal Infirmary M13 9WL2.

To evaluate pregnancy outcomes in women with PCOS we studied a single pregnancy in 46 women with PCOS using 46 controls matched for maternal age, ethnicity and parity. Cases were identified from a laboratory database. The entry criterion for the study was a free androgen index (testosterone/SHBG x100) of 8 or more in symptomatic women investigated in an endocrinology and/or gynaecology clinic. Outcomes studied were pregnancy induced hypertension (PIH, blood pressure > 140/90 on two occasions), impaired glucose tolerance (2h glucose >7.8 mmol/l;75g glucose load) and pre-term labour (<37 weeks). For the infant, birth weight, admission to SCBU and need for resuscitation were recorded. Birth weight in the PCOS group was not significantly different to controls (3511g vs 3350g; p=0.202), neither were macrosomic infants (birth weight >4000g) more common (21.1 % vs 6.5%; p=0.059). PCOS women had more PIH (34.8% vs 8.7%: p=0.005), impaired glucose tolerance (15.2% vs 0 p=0.012) and pre-term labour (17.4% vs 0; p=0.006). PCOS infants required more SCBU admissions (26.7% vs 2.2 %; p=0.002), and resuscitation (53.3% vs 19.6%; p=0.002). In obese PCOS (BMI>30) PIH was more common (65% vs 6.3%) than in non-obese PCOS as was impaired glucose tolerance (30% vs 0; p=0.024) and pre-term labour (37.5% vs 5%; p=0.030). Birth weight was higher in obese than in non-obese PCOS (3774 vs 3186g; p=0.024). There were no differences in SCBU admission 37.5% vs 16 % (p=0.25), or requirement for resuscitation (62.5% vs 52.6%; p=1.0). These results demonstrate that pregnancy complications are more frequent in women with PCOS and indicate that joint protocols between subfertility and obstetric units should be developed for their management.