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• W4387396371 abstract "Ample evidence exists to demonstrate Polycystic Ovarian Syndrome (PCOS) leads to infertility and miscarriage through specific mechanistic pathways of ovulatory dysfunction; however, its relationship with subsequent obstetrical outcomes remains largely unclear, so we aim to investigate this relationship with the following outcomes: hypertensive disorders of pregnancy, gestational diabetes, neonatal mortality, rate of cesarean section (C/S), and premature preterm rupture of membranes (PPROM). To examine our question, we applied to access CDC Pregnancy Risk Assessment of Monitoring System data - a state-based surveillance system. Specifically, we analyzed Standard Core and Phase 8 responses as well as supplemental data from Marijuana and Prescription Drug Use Survey with SPSS 28 software in this retrospective observational study. Two variables were defined that assessed PCOS status in respondents: history of PCOS and PCOS during pregnancy. When history of PCOS is a risk factor, there were significantly increased odds of diabetes (OR 1.665; 95% CI 1.487 - 1.864) and hypertensive disorders (OR 1.589; 95% CI 1.430-1.766) during pregnancy. There were also significantly higher odds of neonatal mortality (OR 1.550 95% CI 1.029-2.335), C/S (OR 1.489; 95% CI 1.269 - 1.747), and PPROM (OR 2.081; 95% 1.335 - 3.242). Using PCOS during pregnancy, there was a significantly greater odds of diabetes (OR 3.278; 95% 2.222 - 4.836) and hypertensive disorders (OR 2.935; 95% 2.003 - 4.302) during pregnancy. Association with C/S (OR 1.378; 95% 0.981 - 1.937) was not significant. PCOS is a significant risk factor that contributes to maternal morbidity including increased risk of hypertensive and diabetic disorders during pregnancy, as well as increased rates of C/S, PPROM, and neonatal mortality. We suggest that PCOS may prime a state of insulin resistance that increases the risk for gestational diabetes; however, published data is contradictory about the significance of this relationship. One hypothesis between PCOS and pre-eclampsia posits that DNA damage inherent within individuals who are obese with PCOS, predisposes them. Further, the deranged metabolic environment within PCOS may cause altered placentation and endovascular changes, predisposing patients to premature delivery and preeclampsia. Linkage between neonatal mortality and PCOS is due to overall increased risk of maternal diabetes and maternal obesity. The increase in C/S can be attributed to elevated BMI, as it is an independent risk factor for labor dystocia. Also, low-grade inflammation associated with PCOS increases PPROM rates through increased IL-18. There still remains much unknown about the link between PCOS and the above obstetrical outcomes, necessitating further investigation." @default.
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• W4387396371 date "2023-10-01" @default.
• W4387396371 modified "2023-10-11" @default.
• W4387396371 title "POLYCYSTIC OVARIAN SYNDROME (PCOS) IMPACT ON OBSTETRICAL MORBIDITY" @default.
• W4387396371 doi "https://doi.org/10.1016/j.fertnstert.2023.08.644" @default.
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