Comment on “Association Between Polycystic Ovary Syndrome and Pregnancy Outcomes in GDM: A Secondary Analysis of the DiGest Trial”
Abstract
Polycystic ovary syndrome (PCOS) affects an estimated 5% to 18% of women and is strongly associated with insulin resistance and long-term metabolic risk. PCOS correlates with higher rates of adverse perinatal outcomes such as hypertensive disorders, preterm birth, and gestational diabetes mellitus (GDM). Because pregnancy itself increases insulin resistance, women with PCOS may represent a higher-risk group for developing GDM. However, whether PCOS independently worsens outcomes in GDM-affected pregnancies remains unclear. Prior studies report mixed results that are limited by small sample sizes and low control for confounding. This study evaluated the impact of PCOS on pregnancy outcomes in women with GDM and assessed whether dietary management is an equally effective intervention in these cases.
This secondary analysis used data from the DiGest trial, a multicenter randomized-controlled trial conducted across eight UK centers that evaluated reduced- versus standard-calorie diets in women with GDM. Eligible participants were adults with singleton pregnancies, a diagnosis of GDM before 30w6d, and a prepregnancy BMI ≥25 kg/m². Participants were randomized between 30 and 32 weeks to receive either a 1200 kcal/day or 2000 kcal/day diet, with meals provided to ensure adherence and blinding. PCOS status was self-reported and the UK uses the Rotterdam Criteria for PCOS diagnosis. This secondary analysis compared maternal and neonatal outcomes between participants with and without…
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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