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Contemporary reproductive outcomes for patients with polycystic ovary syndrome: a retrospective observational study

Rees, Dafydd Aled, Jenkins-Jones, Sara and Morgan, Christopher L. 2016. Contemporary reproductive outcomes for patients with polycystic ovary syndrome: a retrospective observational study. Journal of Clinical Endocrinology & Metabolism 101 (4) , pp. 1664-1672. 10.1210/jc.2015-2682

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Abstract

Context Polycystic ovary syndrome (PCOS) is the commonest cause of anovulatory infertility and may be associated with adverse pregnancy and neonatal outcomes. However, it is difficult to establish how much of this risk is due to PCOS and how much to obesity. Objective To determine the impact of PCOS upon fertility, pregnancy and neonatal outcomes. Design and setting Data were extracted from the Clinical Practice Research Datalink (CPRD), a longitudinal anonymized primary care research database in the UK. Patients with a diagnosis of PCOS were matched to controls (1:2) by age (+/-1 year), BMI (+/- 3 units) and CPRD practice. Standardised fertility ratios (SFR) before and after diagnosis (index date) were calculated. Rates of miscarriage, pre-eclampsia, gestational diabetes, premature delivery, delivery method and neonatal outcomes were compared. Results 9,068 women with PCOS matched study criteria. Prior to index date the SFR for patients with PCOS was 0.80 (95% CI 0.77-0.83); following index date it was 1.16 (1.12-1.20). The adjusted odds ratios (OR) for miscarriage (1.70; 1.56-1.84), pre-eclampsia (1.32; 1.16-1.49), gestational diabetes (1.41; 1.2-1.66) and premature delivery (1.25; 1.1-1.43) were all increased compared to controls. Of PCOS births, 27.7% were by Caesarean section compared with 23.7% of controls (1.13; 1.05-1.21). Infants born to mothers with PCOS had an increased risk of neonatal jaundice (1.20; 1.03-1.39) and respiratory complications (1.20; 1.06-1.37). Conclusions PCOS is associated with subfertility but fertility rates are restored to those of the background population following diagnosis. Pregnancy complications and adverse neonatal outcomes are more prevalent for women with PCOS independently of obesity.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > RG Gynecology and obstetrics
Additional Information: First Published Online: February 09, 2016 Pdf uploaded in accordance with publisher's policy at http://www.sherpa.ac.uk/romeo/issn/0021-972X/ (accessed 11/02/2016)
Publisher: The Endocrine Society
ISSN: 0021-972X
Date of First Compliant Deposit: 30 March 2016
Date of Acceptance: 2 February 2016
Last Modified: 04 Jun 2017 08:52
URI: http://orca.cf.ac.uk/id/eprint/86693

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