Endocrine traits during pregnancy in women with polycystic ovary syndrome - insights from a prospective cohort study in China

Pregnant women with Polycystic ovary syndrome (PCOS) often experience exacerbated endocrine and metabolic dysfunction. While existing studies lack prospective data exist for Chinese populations. Our study aimed to characterize endocrine profiles in Chinese PCOS pregnancies using a prospective cohort. Ninety-one participants (33 PCOS, 58 non-PCOS) were enrolled. Endocrine and metabolic parameters were measured at three trimesters (12–16, 24–28, 32–36 weeks). Primary outcomes included total testosterone (T), sex hormone-binding globulin (SHBG), and free androgen index (FAI). Secondary outcomes covered fasting insulin (FINS), fasting plasma glucose (FPG), triglyceride (TG), total cholesterol (TC), LDL, and HDL. Logistic regression models adjusted for confounders were used for group comparisons. Women with PCOS exhibited higher T and FAI levels compared to women without PCOS across all gestational windows, even after adjusting for factors including pre-pregnancy BMI. Women with PCOS exhibited elevated FINS levels and HOMA-IR at 12–16 weeks and 32-36 weeks of gestation. After adjustment for pre-pregnancy BMI, initial glucose metabolism differences were attenuated and no longer statistically significant. Women with PCOS displayed minor lipid metabolic differences in lipid metabolism. This study highlights complex metabolic changes in PCOS pregnancies, characterized by persistent hyperandrogenism and altered glucose metabolism. Pre-pregnancy BMI might emerge as the key driver of exacerbated glucose dysregulation.