Associations Between Polycystic Ovary Syndrome and Adverse Obstetric and Neonatal Outcomes

A Population Study of 9.1 Million Births

Ginevra Mills; Ahmad Badeghiesh; Eva Suarthana; Haitham Baghlaf; Michael H. Dahan


Hum Reprod. 2020;35(8):1914-1921. 

In This Article


This study represents the largest study in the literature to date assessing PCOS as an independent risk factor for C/S, PTD and PPROM. The data from this study are further useful to address the conflicting data in the literature regarding the increased risk of IOL and SGA infants in PCOS women. Finally, this study represents the first to associate PCOS as an independent risk factor for placental abruption, congenital anomaly, chorioamnionitis and maternal infection. After controlling for closely related conditions, which are known to confer their own increased risk for adverse delivery and neonatal outcomes, including pre-existing metabolic conditions, obesity, GDM, HDP, PEC and multiple gestation, the results of our study confirm that PCOS alone presents a 50% increased risk for C/S delivery and ~44% increased risk for PTD. PCOS, however, does not appear to increase the risk of IOL or SGA infants, as previously suggested. Our data suggest that these outcomes are not independently related to PCOS, but rather may be associated co-morbidities not adequately controlled for in smaller studies. Women with PCOS are ~60% more likely to experience placental abruption and are almost twice as likely to have infants with congenital anomalies than their non-PCOS counterparts. Finally, the risk of developing puerperal infections such as chorioamnionitis, post-partum endometritis and wound infections is increased by ~60% in women with PCOS. Although the results of this study indicate that PCOS alone is indeed an independent risk factor for important delivery outcomes, it is important to consider the risk of all other co-existing medical conditions frequently encountered in PCOS women, as clearly these risks are additive and place women with PCOS at significantly increased risk of adverse complications during pregnancy and delivery as well as adverse neonatal outcomes.