Association between polycystic ovary syndrome and pregnancy outcomes in GDM: A secondary analysis of the DiGest trial
Abstract
Context: Polycystic ovary syndrome (PCOS) is a risk factor for gestational diabetes mellitus (GDM) due to shared pathophysiological associations with insulin resistance and adiposity, and may increase the risk of suboptimal perinatal outcomes in GDM. It is unclear if this excess risk upon outcomes is attributable to PCOS, more severe hyperglycemia, higher maternal BMI or reduced efficacy of dietary interventions.
Objective: To assess associations of PCOS, dietary intervention and gestational weight loss with maternal and neonatal outcomes in women with GDM.
Methods/design: A secondary analysis from the DiGest double-blind randomized controlled trial. Data on self-reported PCOS status were collected at baseline.
Participants: Pregnant women with GDM and BMI ≥25 kg/m2 from 8 UK centers (N = 425; 50 with PCOS and 375 without PCOS).
Intervention: Reduced-energy intervention diet (1200 kcal/day) or standard-energy control diet (2000 kcal/day) from enrollment (29 weeks) until delivery.
Main outcome measures: Pregnancy outcomes, including maternal weight and continuous glucose metrics, physical and dietary data, and infant birthweight and jaundice, were compared between women with and without PCOS using univariate tests and multivariable regression models were applied for adjusted analysis.
Results: Women with GDM and PCOS had similar baseline characteristics, glycemia, BMI, and pregnancy outcomes compared with women with GDM alone, but their infants had higher rates of neonatal…
How strong is the evidence?
Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 425 participants or records.
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