Prevalence and associated factors of gestational diabetes mellitus among women with polycystic ovary syndrome: a systematic review and meta-analysis
Abstract
Objective: Polycystic ovary syndrome (PCOS), the most common endocrine disorder in reproductive-aged women, often leads to gestational diabetes mellitus (GDM). This study aimed to systematically evaluate GDM prevalence and its associated factors in PCOS.
Methods: We searched PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang, Sinomed, and VIP from inception to December 31, 2025. Studies reporting GDM prevalence or associated factors in PCOS were included. A random-effects model pooled prevalence with odds ratios. Egger's test assessed publication bias, and subgroup analysis with meta-regression explored heterogeneity. A logit transformation was applied for pooling.
Results: Twenty-two studies with 5,507 PCOS patients were included. The pooled GDM prevalence was 24% (95% CI: 20%-28%; prediction interval: 10%-46%), with substantial heterogeneity (I² = 89.9%). The primary prevalence estimate, based on cohort studies (n=13), was 21.7% (95% CI: 17.7%-25.8%), while the overall estimate including case-control studies was 24% (95% CI: 20%-28%). By diagnostic criteria, GDM prevalence was 26.0% for one-step vs. 18.7% for two-step. Potentially associated factors included pre-pregnancy BMI (OR = 1.39), gestational weight gain (OR = 1.58), HOMA-IR (OR = 3.41), and family history of diabetes (OR = 2.88).
Conclusion: Although the pooled GDM prevalence in PCOS was 24%, substantial heterogeneity and a wide prediction interval (10%-46%) suggest the true prevalence varies…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 5,507 participants or records.
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