Endocrine Abstracts

Polycystic ovarian syndrome (PCOS) is associated with insulin resistance. Since pregnancy is also known to induce insulin resistance, it is expected that pregnant women with PCOS might be at increased risk for impaired glucose tolerance (IGT) and gestational diabetes mellitus (GDM) which might affect the pregnancy outcome. The incidence of IGT/GDM in PCOS women has not been adequately assessed. The aim of the study was to evaluate glucose tolerance and pregnancy outcome in a group of 22 pregnant women with PCOS.

Methods

All subjects had anovulatory infertility for ≥1 year and fulfilled the criteria of PCOS including at least two of three features: Clinical (hyperandrogenism), Biochemical (elevated FAI, LH and/or LH:FSH) and/or ultrasound features. Insulin sensitivity was measured prior to conception using amended fasting insulin/glucose ratio (IGR). A value of 3.1 was used as a cut off point for normal insulin sensitivity. At 28 weeks gestation all women underwent an oral 75 g glucose tolerance test (GTT). Ethics approval was obtained for this work.

Results

Eighteen women have completed the study at the time of writing this abstract. The mean±sd age of these patients was 28±4.6 kg, BMI 24.4±3.2 kg/m², FAI 4.9±3.4 and LH 14.1±6.6 iu/l. The mean IGR was 2.7±1.8; with four women (22%) having abnormal values (3.8–7.0). Three women (16%) conceived spontaneously, 6(34%) with clomifene citrate and 9(50%) after laparoscopic ovarian drilling. The results of the GTT at 28 weeks gestation were normal in all subjects (fasting glucose 4.5±0.3; two-hour 5.4±1.0 mmol/l). Pregnancy-induced hypertension was observed in 1(6%) and ante-partum haemorrhage in 3(17%) subjects. The birth weight was normal in all cases (3.4±0.9 kg) and no perinatal complication was observed.

Conclusion: PCOS women in this study were mostly non-obese and non-insulin-resistant. It is therefore possible to conclude that this subgroup of PCOS women do not seem to be at increased risk IGT/GDM.