Increased rates of complications in singleton pregnancies of women previously diagnosed with polycystic ovary syndrome predominantly in the hyperandrogenic phenotype

Singleton pregnancies in women with polycystic ovary syndromedespecially those with the hyperandrogenic phenotypedpresent with an increased incidence of complications, especially gestational diabetes.

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Volume 108, Issue 2, Pages 333–340


Marlieke A. de Wilde, M.D., Ph.D., Marije Lamain-de Ruiter, M.Sc., Susanne M. Veltman-Verhulst, M.D., Ph.D., Anneke Kwee, M.D., Ph.D., Joop S. Laven, M.D., Ph.D., Cornelis B. Lambalk, M.D., Ph.D., Marinus J.C. Eijkemans, M.D., Ph.D., Arie Franx, M.D., Ph.D., Bart C.J.M. Fauser, M.D., Ph.D., Maria P.H. Koster, M.D., Ph.D.



To study the presence of several maternal and neonatal complications in a cohort of women with hyperandrogenic as well as normoandrogenic polycystic ovary syndrome (PCOS) and women with PCOS who received different fertility treatments.


Prospective multicenter cohort study.


Hospitals and midwifery practices.


One hundred and eighty-eight women with PCOS and singleton pregnancies (study group) and 2,889 women with a naturally conceived singleton pregnancy (reference group).


Observational study.

Main Outcome Measure(s)

Maternal and neonatal pregnancy complications.


Women with PCOS had a statistically significantly increased risk of developing gestational diabetes (adjusted odds ratio [AOR] 4.15; 95% confidence interval [CI], 2.07–8.33) compared with the reference group, and their infants were more often born small for gestational age (AOR 3.76; 95% CI, 1.69–8.35). In a subgroup analysis, maternal complications were statistically significantly more often present in women with hyperandrogenic (defined as a free androgen index >4.5) PCOS (n = 76; 40% of all PCOS women) compared with those with normoandrogenic PCOS (n = 97; 52% of all PCOS women) (45% vs. 24%; P=.003); no statistically significant differences were observed between these groups regarding neonatal complications.


Women with PCOS have an increased risk of maternal and neonatal pregnancy complications, especially women with the hyperandrogenic phenotype.

Clinical Trial Registration Number


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.