Maternal and Neonatal Complications in Pregnant Women With Polyendocrine Metabolic Ovarian Syndrome: A Nested Prospective Cohort Study

OBJECTIVE To investigate associations between polyendocrine metabolic ovarian syndrome (PMOS) and maternal and neonatal outcomes and explore interactions with BMI and ethnicity. RESEARCH DESIGN AND METHODS This was a prospective nested cohort study of pregnant women with risk factors for hyperglycemia enrolled in an international, multicenter, randomized controlled trial of gestational diabetes mellitus (GDM) treatment. We compared baseline and pregnancy characteristics, evaluated adverse maternal and neonatal outcomes by PMOS status, and used multivariable regression models to evaluate factors (maternal age, baseline BMI, ethnicity, parity, smoking, and level of education) that independently affected maternal and neonatal outcomes. RESULTS Of 3,645 participants, PMOS prevalence was 17.1% (95% CI 15.9, 18.3). At booking visits, women with PCOS (vs. without) were younger (30.6 ± 4.7 vs. 31.3 ± 5.2 years; P < 0.001) and had higher median (interquartile range) BMI at baseline (29.8 [25.1–35.7] vs. 28.1 [24.1–33.9] kg/m2; P < 0.001), and more were primigravid (30.2% [n = 188] vs. 25.7% [n = 778]; P = 0.022). There were positive associations between PCOS and early GDM, with an adjusted odds ratio (aOR) of 1.37 (95% CI 1.10, 1.72), a composite of adverse neonatal outcomes (aOR 1.28 [95% CI 1.04, 1.58]), admission to a neonatal special care nursery or neonatal intensive care unit (aOR 1.32 [95% CI 1.05–1.65]), and negative associations between PMOS and gestational age at birth (−1.60 days [95% CI −2.82, −0.39]) and birth length (−0.33 cm [95% CI −0.61, −0.04]). No interactions were found with baseline BMI and ethnicity. CONCLUSIONS PMOS was associated with higher odds of early GDM, and neonatal outcomes were poorer on adjusted analyses, highlighting independent pregnancy risks in PMOS and the need to identify, monitor, and treat women with PMOS to mitigate risks of adverse pregnancy outcomes.

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Journal
Diabetes Care
Published
2026-09-16
DOI
https://doi.org/10.2337/dc25-1704
Primary Topic
Gestational Diabetes Research and Management
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article
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article

Maternal and Neonatal Complications in Pregnant Women With Polyendocrine Metabolic Ovarian Syndrome: A Nested Prospective Cohort Study

Jacqueline Boyle, Ranjit Mohan Anjana, Parneet Sethi, William M. Hague et al.
Diabetes Care
Gestational Diabetes Research and Management
article

Maternal and Neonatal Complications in Pregnant Women With Polyendocrine Metabolic Ovarian Syndrome: A Nested Prospective Cohort Study

Jacqueline Boyle, Ranjit Mohan Anjana, Parneet Sethi, William M. Hague, Mark McLean, Lisa Moran, Michael Peek, Helena Teede, Jürgen Harreiter, Jeff R. Flack, Herbert Kiss, Vincent Wong, N. WAH CHEUNG, Viswanathan Mohan, Rohit Rajagopal, Raiyomand Dalal, Alexandra Kautzky‐Willer, Adriana C. H. Neven, David Simmons, Aya Mousa, Christopher J. Nolan, Arianne Sweeting, Joanne Enticott, Georgia Soldatos, Jincy Immanuel, Helena Backman, Erik Schwarcz, E Jona, N. Wah Cheung, Suzette Coat, Emily Hibbert, Uma Ram, Christopher J. Nolan, Joanne Enticott, Emily Hibbert, Arianne Sweeting, Glynis Ross, EMILY GIANATTI, Michael J. Peek, Vincent Wong, Mark Mclean, Jeff Flack, David Simmons, Victoria Rudland, Helena Backman, Helena Teede, Mahnaz Bahri Khomami, Alexandra Kautzky-Willer
article en

Abstract

OBJECTIVE To investigate associations between polyendocrine metabolic ovarian syndrome (PMOS) and maternal and neonatal outcomes and explore interactions with BMI and ethnicity. RESEARCH DESIGN AND METHODS This was a prospective nested cohort study of pregnant women with risk factors for hyperglycemia enrolled in an international, multicenter, randomized controlled trial of gestational diabetes mellitus (GDM) treatment. We compared baseline and pregnancy characteristics, evaluated adverse maternal and neonatal outcomes by PMOS status, and used multivariable regression models to evaluate factors (maternal age, baseline BMI, ethnicity, parity, smoking, and level of education) that independently affected maternal and neonatal outcomes. RESULTS Of 3,645 participants, PMOS prevalence was 17.1% (95% CI 15.9, 18.3). At booking visits, women with PCOS (vs. without) were younger (30.6 ± 4.7 vs. 31.3 ± 5.2 years; P < 0.001) and had higher median (interquartile range) BMI at baseline (29.8 [25.1–35.7] vs. 28.1 [24.1–33.9] kg/m2; P < 0.001), and more were primigravid (30.2% [n = 188] vs. 25.7% [n = 778]; P = 0.022). There were positive associations between PCOS and early GDM, with an adjusted odds ratio (aOR) of 1.37 (95% CI 1.10, 1.72), a composite of adverse neonatal outcomes (aOR 1.28 [95% CI 1.04, 1.58]), admission to a neonatal special care nursery or neonatal intensive care unit (aOR 1.32 [95% CI 1.05–1.65]), and negative associations between PMOS and gestational age at birth (−1.60 days [95% CI −2.82, −0.39]) and birth length (−0.33 cm [95% CI −0.61, −0.04]). No interactions were found with baseline BMI and ethnicity. CONCLUSIONS PMOS was associated with higher odds of early GDM, and neonatal outcomes were poorer on adjusted analyses, highlighting independent pregnancy risks in PMOS and the need to identify, monitor, and treat women with PMOS to mitigate risks of adverse pregnancy outcomes.

Diabetes Care
Australian National University (AU), Camden and Campbelltown Hospitals (AU), The University of Sydney (AU), Örebro University (SE), Royal Prince Alfred Hospital (AU), Bankstown Lidcombe Hospital (AU), Fiona Stanley Hospital (AU), Liverpool Hospital (AU), Nepean Hospital (AU), Blacktown & Mount Druitt Hospital (AU), Canberra Hospital (AU), Westmead Hospital (AU), Madras Diabetes Research Foundation (IN), Monash Health (AU), Dr. Mohan's Diabetes Specialities Centre (IN), Monash University (AU), The University of Adelaide (AU), Medical University of Vienna (AT)
Good health and well-being
Openalex Percentile: Top 8%
Gestational Diabetes Research and Management
DOISourceOpenAlex
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