REVIEW  INFERTILITY AND PREGNANCY OUTCOME 

Minerva Obstetrics and Gynecology 2022 February;74(1):45-59

DOI: 10.23736/S2724-606X.21.04758-4

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Pregnancy outcomes in women with polycystic ovarian syndrome

Maurizio N. D’ALTERIO ¹ ✉, Marco SIGILLI ¹, Antonio G. SUCCU ¹, Valeria GHISU ¹, Antonio S. LAGANÀ ², Felice SORRENTINO ³, Luigi NAPPI ³, Raffaele TINELLI ⁴, Stefano ANGIONI ¹

¹ Division of Obstetrics and Gynecology, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy; ² Department of Obstetrics and Gynecology, Filippo del Ponte Hospital, University of Insubria, Varese, Italy; ³ Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, Foggia, Italy; ⁴ Department of Obstetrics and Gynecology, Valle d’Itria’ Hospital, Martina Franca, Taranto, Italy

Polycystic ovarian syndrome (PCOS) is the most common endocrinological disease of reproductive-aged women, with an estimated incidence ranging from 5% to 15%. The clinical manifestations of PCOS are heterogeneous and vary according to the age of the patient. Insulin resistance (IR), hyperandrogenism, and obesity are widely assumed to play a pivotal role in the pathophysiological mechanism of PCOS. As previously stated by many conducted meta-analyses, PCOS can cause a rising risk of pregnancy complications, including maternal, fetal, and neonatal complications. Pregnancy-induced hypertension (PIH), preeclampsia (PE), gestational diabetes mellitus (GDM), spontaneous preterm birth (PTB), and an increased necessity for a cesarean section (CS) are the most documented maternal implications. Regarding fetal outcomes, PCOS has also been correlated with elevated neonatal morbidity, prematurity, fetal growth restriction (FGR), birth weight variations (large for gestational age [LGA] and small for gestational age [SGA]), and transfer to the Neonatal Intensive Care Unit (NICU). Owing to the variability of the studies performed, the association of PCOS with an elevated risk of adverse pregnancy outcomes is still controversial. This variability is found in the diagnosis and clinical presentations of PCOS, and can be influenced by prepregnancy circumstances and therapies as well as particular population and environmental features. The Amsterdam Consensus Guidelines confirm that obesity and IR can worsen maternal and fetal complications; thus, a closer follow-up should be offered to PCOS women during pregnancy.

KEY WORDS: Polycystic ovary syndrome; Pregnancy outcome; Obesity; Insulin resistance; Hyperandrogenism