The Journal of clinical endocrinology and metabolism · 2018
Gestational Weight Gain in Women With Polycystic Ovary Syndrome: A Controlled Study.
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Kent James, Dodson William C, Kunselman Allen, Pauli Jaimey, Stone Alicia, Diamond Michael P, Coutifaris Christos, Schlaff William D, Alvero Ruben, Casson Peter, Christman Gregory M, Rosen R Mitchell, Hansen Karl R, Robinson Randall D, Baker Valerie, Usadi Rebecca, Santoro Nanette, Zhang Heping, Eisenberg Esther, Legro Richard S, Reproductive Medicine Network
Аннотация
CONTEXT: Women with polycystic ovary syndrome (PCOS) have increased risk for pregnancy complications, possibly related to pre-existing obesity and excessive gestational weight gain (GWG).
OBJECTIVES: To assess the contributions of diagnosis and preconception weight on GWG and perinatal outcomes.
RESEARCH DESIGN AND METHODS: Prospective cohort study of singleton pregnancies in PCOS (n = 164) and ovulatory controls (n = 176) from infertility treatment.
MAIN OUTCOME MEASURES: GWG, birthweight, pregnancy complications.
RESULTS: From preconception baseline, normal-weight women with PCOS gained 2.3 pounds more during the first trimester (95% CI, 0.3 to 4.3; P = 0.02), and by the end of the second trimester, 4.2 pounds more than controls (95% CI, 0.7 to 7.7; P = 0.02). Women who were overweight with PCOS gained significantly more weight than did controls by the end of the second trimester (5.2 pounds; 95% CI, 0.2 to 10.2; P = 0.04), whereas women with obesity and PCOS and control women had similar weight gain throughout pregnancy. Within normal-weight, overweight, and obese groups, prevalence of pre-eclampsia and gestational diabetes did not differ between the PCOS and control groups, nor was there a difference in birthweight. Preconception body mass index (BMI) was significantly associated with GWG; for every 1-kg/m2 increase in preconception BMI, GWG decreased by 0.62 pounds (95% CI, -0.85 to -0.40; P < 0.001).
CONCLUSIONS: Women with PCOS who are of normal weight or are overweight before conception experience more GWG than do ovulatory controls. Within normal-weight, overweight, and obese groups, rates of perinatal complications do not significantly differ between women with PCOS and controls. Preconception BMI is the strongest predictor of GWG.
OBJECTIVES: To assess the contributions of diagnosis and preconception weight on GWG and perinatal outcomes.
RESEARCH DESIGN AND METHODS: Prospective cohort study of singleton pregnancies in PCOS (n = 164) and ovulatory controls (n = 176) from infertility treatment.
MAIN OUTCOME MEASURES: GWG, birthweight, pregnancy complications.
RESULTS: From preconception baseline, normal-weight women with PCOS gained 2.3 pounds more during the first trimester (95% CI, 0.3 to 4.3; P = 0.02), and by the end of the second trimester, 4.2 pounds more than controls (95% CI, 0.7 to 7.7; P = 0.02). Women who were overweight with PCOS gained significantly more weight than did controls by the end of the second trimester (5.2 pounds; 95% CI, 0.2 to 10.2; P = 0.04), whereas women with obesity and PCOS and control women had similar weight gain throughout pregnancy. Within normal-weight, overweight, and obese groups, prevalence of pre-eclampsia and gestational diabetes did not differ between the PCOS and control groups, nor was there a difference in birthweight. Preconception body mass index (BMI) was significantly associated with GWG; for every 1-kg/m2 increase in preconception BMI, GWG decreased by 0.62 pounds (95% CI, -0.85 to -0.40; P < 0.001).
CONCLUSIONS: Women with PCOS who are of normal weight or are overweight before conception experience more GWG than do ovulatory controls. Within normal-weight, overweight, and obese groups, rates of perinatal complications do not significantly differ between women with PCOS and controls. Preconception BMI is the strongest predictor of GWG.