Comparing the risk of adverse pregnancy outcomes of Chinese patients with polycystic ovary syndrome with and without antiandrogenic pretreatment

In Chinese patients with polycystic ovary syndrome, antiandrogenic pretreatment is associated with a de- crease in adverse pregnancy outcomes such as gestational diabetes mellitus, pregnancy-induced hypertension, and premature delivery.

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Volume 109, Issue 4, Pages 720–727

Authors:

Yanglu Li, M.D., Xiangyan Ruan, M.D., Ph.D., Husheng Wang, B.S., Xue Li, B.S., Guiju Cai, M.D., Juan Du, M.D., Lijuan Wang, B.S., Yue Zhao, Ph.D., Alfred O. Mueck, M.D., Pharm.D., Ph.D.

Abstract:

Objective

To evaluate the prevalence of adverse pregnancy outcomes in healthy Chinese women and to investigate whether these outcomes could be decreased in patients with polycystic ovary syndrome (PCOS) by ethinylestradiol/cyproterone acetate (EE/CPA) pretreatment.

Design

Retrospective study.

Setting

Medical university.

Patient(s)

Six thousand healthy women (group A) were selected from 24,566 pregnant women by randomized sampling. Four hundred forty-eight patients with PCOS without EE/CPA pretreatment were assigned to group B, and 222 patients with PCOS with 3 months of pretreatment to group C. All patients with PCOS had biochemical and/or clinical hyperandrogenism and conceived within 3 monthly ovulation inductions using clomiphene.

Intervention(s)

None.

Main Outcome Measure(s)

Gestational diabetes mellitus (GDM), pregnancy-induced hypertension (PIH), premature delivery (PD), and neonatal birth weight.

Result(s)

The prevalence of GDM, PIH, and PD was higher in group B than in groups A and C (A vs. B vs. C: GDM, 21.2% vs. 35.0% vs. 22.5%; PIH, 6.5% vs. 14.1% vs. 7.7%; PD, 5.4% vs. 8.6% vs. 6.8%). No significant difference was found in neonatal birth weight. After adjusting for age, pregestational body mass index, education level, and employment status, PCOS without pretreatment increased the risk of GDM (adjusted odds ratio [aOR] = 1.666; 95% confidence interval [CI], 1.340–2.072), PIH (aOR = 1.487; 95% CI, 1.093–2.023), and PD (aOR = 1.522; 95% CI 1.051–2.205), compared with healthy women. No increased risk was found in group C.

Conclusion(s)

In our highly selected study population, patients with PCOS are more likely to develop GDM, PIH, and PD. Pretreatment with EE/CPA was associated with a lower risk of GDM, PIH, and PD.


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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. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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