Increased maternal pregnancy complications in polycystic ovary syndrome appear to be independent of obesity—A systematic review, meta‐analysis, and meta‐regression
Abstract
Polycystic ovary syndrome (PCOS) is associated with an increased risk of maternal pregnancy and delivery complications. However, the impact of clinical features of PCOS and other potential risk factors in PCOS is still unknown. We aimed to investigate the association of PCOS with maternal pregnancy and delivery complications with consideration of risk factors and potential confounders. The meta-analysis included 63 studies. PCOS was associated with higher miscarriage, gestational diabetes mellitus, gestational hypertension, pre-eclampsia, induction of labour, and caesarean section. The association of PCOS with these outcomes varied by geographic continent, PCOS phenotypes, and study quality. Pre-eclampsia and induction of labour were not associated with PCOS on body mass index-matched studies. No outcome was associated with PCOS on assisted pregnancies. Age was significantly associated with higher miscarriage on meta-regression. There were no studies assessing perinatal depression. We confirm that PCOS is associated with an increased risk of maternal pregnancy and delivery complications. The association of PCOS with the outcomes is worsened in hyperandrogenic PCOS phenotypes, in specific geographic continents, and in the highest quality studies but disappears in assisted pregnancies. Future studies in PCOS are warranted to investigate proper timing for screening and prevention of maternal pregnancy and delivery complications with consideration of clinical features of PCOS.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Those with PCOS have an increased risk of pregnancy complications such as gestational diabetes and pre-eclampsia, and post-partum risk for diabetes and cardiovascular disease.
“Those with PCOS have an increased risk of pregnancy complications such as gestational diabetes and pre-eclampsia, and post-partum risk for diabetes and cardiovascular disease.”
From Challenges in diagnosis and health care in polycystic ovary syndrome in Canada: a patient view to improve health care (2023) · cites this paper as [56]
PCOS is associated with a higher incidence of fertility assistance and complications of pregnancy, including gestational hypertension and diabetes.
“PCOS is associated with a higher incidence of fertility assistance and complications of pregnancy, including gestational hypertension and diabetes.12,17,18,21, 22, 23, 24”
From Increased Prevalence of Adverse Health Outcomes Across the Lifespan in Those Affected by Polycystic Ovary Syndrome: A Canadian Population Cohort (2024) · cites this paper as [21]
Cites
A meta-analysis of pregnancy outcomes in women with polycystic ovary syndrome
Boomsma, C. M., Eijkemans, M. J. C., Hughes, E. G., Visser, G. H. A., Fauser, B. C. J. M., & Macklon, N. S. (2006) · Human Reproduction Update · doi:10.1093/humupd/dml036 · Cited by 852 · see citing works
The Potential Implications of a PCOS Diagnosis on a Woman's Long-Term Health Using Data Linkage
Hart, R., & Doherty, D. A. (2015) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2014-3886 · Cited by 391 · see citing works
Maternal Prepregnancy Body Mass Index and Gestational Weight Gain on Pregnancy Outcomes
Li, N., Liu, E., Guo, J., Pan, L., Li, B., Wang, P., Liu, J., Wang, Y., Liu, G., Baccarelli, A. A., et al. (2013) · PLoS ONE · doi:10.1371/journal.pone.0082310 · Cited by 356 · see citing works
Qin, J. Z., Pang, L. H., Li, M. J., Fan, X. J., Huang, R. D., & Chen, H. Y. (2013) · Reproductive Biology and Endocrinology · doi:10.1186/1477-7827-11-56 · Cited by 317 · see citing works
Vanky, E., Stridsklev, S., Heimstad, R., Romundstad, P., Skogøy, K., Kleggetveit, O., Hjelle, S., von Brandis, P., Eikeland, T., Flo, K., et al. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-0853 · Cited by 315 · see citing works
Obstetric outcome in women with polycystic ovarian syndrome
Mikola, M. (2001) · Human Reproduction · doi:10.1093/humrep/16.2.226 · Cited by 206 · see citing works
Lo, J. C., Feigenbaum, S. L., Escobar, G. J., Yang, J., Crites, Y. M., & Ferrara, A. (2006) · Diabetes Care · doi:10.2337/dc06-0877 · Cited by 112 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Update on PCOS: consequences, challenges, and guiding treatment
Hoeger, K. M., Dokras, A., & Piltonen, T. (2021) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgaa839 · Cited by 610 · see citing works
Self-citationStener-Victorin, E., Teede, H., Norman, R. J., Legro, R., Goodarzi, M. O., Dokras, A., Laven, J., Hoeger, K., & Piltonen, T. T. (2024) · Nature Reviews Disease Primers · doi:10.1038/s41572-024-00511-3 · Cited by 495 · see citing works
Self-citationDiabetes: A metabolic and reproductive disorder in women
Thong, E. P., Codner, E., Laven, J. S. E., & Teede, H. (2020) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(19)30345-6 · Cited by 242 · see citing works
Self-citationRiestenberg, C., Jagasia, A., Markovic, D., Buyalos, R. P., & Azziz, R. (2022) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgab613 · Cited by 210 · see citing works
Gestational Diabetes Mellitus and Preeclampsia: Correlation and Influencing Factors
Yang, Y., & Wu, N. (2022) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2022.831297 · Cited by 155 · see citing works
Sydora, B. C., Wilke, M. S., McPherson, M., Chambers, S., Ghosh, M., & Vine, D. F. (2023) · BMC Women's Health · doi:10.1186/s12905-023-02732-2 · Cited by 60 · see citing works
Vine, D., Ghosh, M., Wang, T., & Bakal, J. (2024) · CJC Open · doi:10.1016/j.cjco.2023.12.010 · Cited by 53 · see citing works
Fernandez, R. C., Moore, V. M., Rumbold, A. R., Whitrow, M. J., Avery, J. C., & Davies, M. J. (2021) · Human Reproduction · doi:10.1093/humrep/deab101 · Cited by 50 · see citing works
Fornes, R., Simin, J., Nguyen, M. H., Cruz, G., Crisosto, N., van der Schaaf, M., Engstrand, L., & Brusselaers, N. (2022) · Reproductive Biology and Endocrinology · doi:10.1186/s12958-022-00905-6 · Cited by 44 · see citing works
Pirotta, S., Joham, A., Grieger, J. A., Tay, C. T., Bahri-Khomami, M., Lujan, M., Lim, S. S., & Moran, L. J. (2020) · Seminars in Reproductive Medicine · doi:10.1055/s-0041-1726866 · Cited by 29 · see citing works
Self-citation
- Authors
- Bahri Khomami, M., Joham, A. E., Boyle, J. A., Piltonen, T., Silagy, M., Arora, C., Misso, M. L., Teede, H. J., & Moran, L. J.
- Affiliations
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine Monash University Melbourne Australia
- Monash Health (AU)
- Oulu University Hospital (FI)
- Monash University (AU)
- Corresponding author
- Moran, Lisa J.
- ORCID
- Venue
- Obesity Reviews
- Publisher
- Wiley
- Published
- 2019-01-23
- Volume
- 20
- Issue
- 5
- Pages
- 659-674
- ISSN
- 1467-7881 (ISSN-L)
- 1467-789X
- OpenAlex
- W2911959152
- Cited by
- 211
- References
- 7
- Citations by year
- 2026: 22 · 2025: 23 · 2024: 39 · 2023: 41 · 2022: 32 · 2021: 24 · 2020: 22 · 2019: 8
- FWCI
- 3.02
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obesity Reviews (publishedVersion)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Funders
- Monash University
- National Health and Medical Research Council
- National Heart Foundation of Australia
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Keywords
- polycystic ovary syndrome, pregnancy complications, delivery complications, miscarriage, gestational diabetes mellitus, gestational hypertension, preeclampsia, labor induction, cesarean section, body mass index, assisted reproduction, perinatal depression, risk factors
- MeSH terms
- Cesarean Section, Female, Humans, Obesity, Polycystic Ovary Syndrome, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Risk Factors, Body Mass Index, Premature Birth
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
