PREGNANCY OUTCOMES IN A COHORT OF PATIENTS WITH POLYCYSTIC OVARIAN SYNDROME
(PCOS) AT THE UNIVERSITY HOSPITAL OF THE WEST INDIES (UHWI) BETWEEN 2012-2023

 

INTRODUCTION 

• PCOS is characterized by hyperandrogenism, ovarian

dysfunction and hyperinsulinemia with reproductive

consequences

• Most common endocrine disorder in women of

reproductive age with reported prevalence of 6-15%¹

• Cardiovascular, endocrine and metabolic sequelae increase

the risk of adverse pregnancy and neonatal outcomes

• Currently, there is a gap in existing literature on its

prevalence and adverse pregnancy outcomes in a

predominantly Afrocentric population

Aim of study: To determine the health outcomes of pregnant

women with PCOS at the University Hospital of the West

Indies (UHWI) between 2012-2023

METHODOLOGY 

• Retrospective cohort study of obstetric patients seen at the

UHWI between January 1, 2012 - December 31, 2023.

• Cases were identified using documentation in the Labour

Ward records and subsequent docket review. Controls were

age-matched and delivered within a week of the index

cases.

• Sample size = 226 (113 cases, 113 controls) [79 cases

and 109 controls at time of preliminary analysis]

• Women with multiple gestation, pre-existing diabetes,

prior history of gestational diabetes (GDM) and age <18

or >45 were excluded

• Data on maternal and neonatal demographics, clinical

course and pregnancy outcomes were collected.

• Descriptive, bivariate and multivariate analyses were done.

Statistical significance was set at p<0.05

 

DISCUSSION 

• Previous meta-analyses ^2-4 found that GDM was 3x more likely in

women with PCOS. Similar findings were noted in our study with a 20x

increased risk likely due to the ethnicity of our study population.

• A systematic review done in 2011³ found that PIH was 3-4x more likely

in PCOS patients. Results were similar in our population where it was

found to be 3x more likely.

• A recent meta-analysis published in May 2024⁵ identified a 5.3x

increased risk of cervical insufficiency in patients with PCOS. This was

similar to the findings of this study which identified a 7.5x increased

risk.

• After adjusting for confounders, there was a significant association

between PCOS and hypertension. However, there was no significant

association between PCOS and GDM or PIH.

 

CONCLUSION

• Adverse pregnancy outcomes were similar to those reported in

existing literature. However, the relationship between PCOS and GDM

as well as PCOS and PIH was confounded by obesity

• The association with HTN may have clinical implications (prophylactic

aspirin therapy)

• The association with cervical insufficiency may also have clinical

implications (cervical surveillance)

• The type D phenotype was most prevalent in our population

suggesting that anovulation, rather than hyperandrogenism, may be

the predominant clinical feature.

 

REFERENCES 

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