Polycystic ovary syndrome and pregnancy - review
Keywordspolicystic ovary syndrome, obesity, pregnancy
Introduction and purpose
Polycystic Ovary Syndrome(PCOS) is one of the most common endocrinological disorders, and it affects 7-8 % of women globally. It is very heterogenous disease, which pathogenesis is complex and composed of many factors like genetics, hormonal changes, environmental factors and insulin resistance. PCOS has many symptoms, which appearance is dependent on comorbidities like obesity, diabetes mellitus, hypercholesterolemia. Due to complexity of the pathogenesis of PCOS it may have four phenotypes: A,B,C,D. The pregnancy pathologies connected to PCOS are mainly gestational diabetes mellitus, pregnancy induced hypertension. Pregnant women with PCOS have 3-4 times a higher risk of developing pregnancy induced hypertension (PIH) and preeclampsia and a three times higher risk of gestational diabetes mellitus (GDM). More than 64% of pregnancies in women with PCOS were terminated via caesarean section. Metformin, although still controversial may be a good option for the treatment of PCOS before and during pregnancy as a second-line therapy.
PCOS is a disease which affects the women in childbearing age and may have negative impact on its course. Pathologies connected to PCOS during pregnancy affect not only mothers, but foetus and according to new researches also children and adults from mothers with PCOS. It is very essential to extract women with PCOS to implement treatment and prevent its complications. Moreover, due to its common association with obesity patients should be under cardiologists care due to higher cardiovascular risk.
Galluzzo, A., Amato, M. C., & Giordano, C. (2008). Insulin resistance and polycystic ovary syndrome. Nutrition, metabolism, and cardiovascular diseases : NMCD, 18(7), 511–518. https://doi.org/10.1016/j.numecd.2008.05.004
Goudas, V. T., & Dumesic, D. A. (1997). Polycystic ovary syndrome. Endocrinology and metabolism clinics of North America, 26(4), 893–912. https://doi.org/10.1016/s0889-8529(05)70286-3
Wild R. A. (2012). Dyslipidemia in PCOS. Steroids, 77(4), 295–299. https://doi.org/10.1016/j.steroids.2011.12.002
Yu, Hai-Feng MS; Chen, Hong-Su MS; Rao, Da-Pang MS; Gong, Jian MS Association between polycystic ovary syndrome and the risk of pregnancy complications, Medicine: December 2016 - Volume 95 - Issue 51 - p e4863 doi: 10.1097/MD.0000000000004863
Baskind, N. E., & Balen, A. H. (2016). Hypothalamic-pituitary, ovarian and adrenal contributions to polycystic ovary syndrome. Best practice & research. Clinical obstetrics & gynaecology, 37, 80–97. https://doi.org/10.1016/j.bpobgyn.2016.03.005
Deslypere, J. P., Verdonck, L., & Vermeulen, A. (1985). Fat tissue: a steroid reservoir and site of steroid metabolism. The Journal of clinical endocrinology and metabolism, 61(3), 564–570. https://doi.org/10.1210/jcem-61-3-564
Siiteri P. K. (1987). Adipose tissue as a source of hormones. The American journal of clinical nutrition, 45(1 Suppl), 277–282. https://doi.org/10.1093/ajcn/45.1.277
Baptiste, C. G., Battista, M. C., Trottier, A., & Baillargeon, J. P. (2010). Insulin and hyperandrogenism in women with polycystic ovary syndrome. The Journal of steroid biochemistry and molecular biology, 122(1-3), 42–52. https://doi.org/10.1016/j.jsbmb.2009.12.010
Khan, M. J., Ullah, A., & Basit, S. (2019). Genetic Basis of Polycystic Ovary Syndrome (PCOS): Current Perspectives. The application of clinical genetics, 12, 249–260. https://doi.org/10.2147/TACG.S200341
Nowaczyk, A., Kowalska, M., Nowaczyk, J., & Grześk, G. (2021). Carbon Monoxide and Nitric Oxide as Examples of the Youngest Class of Transmitters. International journal of molecular sciences, 22(11), 6029. https://doi.org/10.3390/ijms22116029
Grześk, G., & Nowaczyk, A. (2021). Current Modulation of Guanylate Cyclase Pathway Activity-Mechanism and Clinical Implications. Molecules (Basel, Switzerland), 26(11), 3418. https://doi.org/10.3390/molecules26113418
Lakhani, K., Leonard, A., Seifalian, A. M., & Hardiman, P. (2005). Microvascular dysfunction in women with polycystic ovary syndrome. Human reproduction (Oxford, England), 20(11), 3219–3224. https://doi.org/10.1093/humrep/dei199
Zheng, Q., Li, Y., Zhang, D., Cui, X., Dai, K., Yang, Y., ... & Yan, Q. (2017). ANP promotes proliferation and inhibits apoptosis of ovarian granulosa cells by NPRA/PGRMC1/EGFR complex and improves ovary functions of PCOS rats. Cell death & disease, 8(10), e3145-e3145.
Namavar Jahromi, B., Zolghadri, J., Rahmani, E., Alipour, S., Anvar, Z., Zarei, A., & Keramati, P. (2019). Effect of low-dose aspirin on the development of ovarian hyperstimulation syndrome and outcomes of assisted reproductive techniques in the women with PCOS, a randomized double-blinded clinical trial. Taiwanese journal of obstetrics & gynecology, 58(2), 255–260. https://doi.org/10.1016/j.tjog.2019.01.016
Grześk, G., Kozinski, M., Tantry, U. S., Wicinski, M., Fabiszak, T., Navarese, E. P., ... & Kubica, J. (2013). High-dose, but not low-dose, aspirin impairs anticontractile effect of ticagrelor following ADP stimulation in rat tail artery smooth muscle cells. BioMed research international, 2013.
Grześk, G., Rogowicz, D., Wołowiec, Ł., Ratajczak, A., Gilewski, W., Chudzińska, M., ... & Banach, J. (2021). The clinical significance of drug–food interactions of direct oral anticoagulants. International Journal of Molecular Sciences, 22(16), 8531.
Chudzińska, M., Rogowicz, D., Wołowiec, Ł., Banach, J., Sielski, S., Bujak, R., ... & Grześk, G. (2021). Resveratrol and cardiovascular system—The unfulfilled hopes. Irish Journal of Medical Science (1971-), 190(3), 981-986.
Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group (2004). Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Human reproduction (Oxford, England), 19(1), 41–47. https://doi.org/10.1093/humrep/deh098
Bozdag, G., Mumusoglu, S., Zengin, D., Karabulut, E., & Yildiz, B. O. (2016). The prevalence and phenotypic features of polycystic ovary syndrome: a systematic review and meta-analysis. Human reproduction (Oxford, England), 31(12), 2841–2855. https://doi.org/10.1093/humrep/dew218
Wang, T., Fu, H., Chen, L., & Xu, Y. (2017). Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences, 42(11), 1300–1310. https://doi.org/10.11817/j.issn.1672-7347.2017.11.010
Palomba, S., de Wilde, M. A., Falbo, A., Koster, M. P., La Sala, G. B., & Fauser, B. C. (2015). Pregnancy complications in women with polycystic ovary syndrome. Human reproduction update, 21(5), 575–592. https://doi.org/10.1093/humupd/dmv029
Yu, H. F., Chen, H. S., Rao, D. P., & Gong, J. (2016). Association between polycystic ovary syndrome and the risk of pregnancy complications: A PRISMA-compliant systematic review and meta-analysis. Medicine, 95(51), e4863. https://doi.org/10.1097/MD.0000000000004863
Bafghi, A., & Shamsi, F. (2020). Maternal and neonatal outcomes among pregnant women with different polycystic ovary syndrome phenotypes: A cross-sectional study. International journal of reproductive biomedicine, 18(5), 339–346. https://doi.org/10.18502/ijrm.v13i5.7154
Qin, J. Z., Pang, L. H., Li, M. J., Fan, X. J., Huang, R. D., & Chen, H. Y. (2013). Obstetric complications in women with polycystic ovary syndrome: a systematic review and meta-analysis. Reproductive biology and endocrinology : RB&E, 11, 56. https://doi.org/10.1186/1477-7827-11-56
Kollmann, M., Klaritsch, P., Martins, W. P., Guenther, F., Schneider, V., Herzog, S. A., Craciunas, L., Lang, U., Obermayer-Pietsch, B., Lerchbaum, E., & Raine-Fenning, N. (2015). Maternal and neonatal outcomes in pregnant women with PCOS: comparison of different diagnostic definitions. Human reproduction (Oxford, England), 30(10), 2396–2403. https://doi.org/10.1093/humrep/dev187
Fornes, R., Simin, J., Nguyen, M. H., Cruz, G., Crisosto, N., van der Schaaf, M., Engstrand, L., & Brusselaers, N. (2022). Pregnancy, perinatal and childhood outcomes in women with and without polycystic ovary syndrome and metformin during pregnancy: a nationwide population-based study. Reproductive biology and endocrinology : RB&E, 20(1), 30. https://doi.org/10.1186/s12958-022-00905-6
Ghazeeri, G. S., Nassar, A. H., Younes, Z., & Awwad, J. T. (2012). Pregnancy outcomes and the effect of metformin treatment in women with polycystic ovary syndrome: an overview. Acta obstetricia et gynecologica Scandinavica, 91(6), 658–678. https://doi.org/10.1111/j.1600-0412.2012.01385.x
Singh, A. K., & Singh, R. (2015). Metformin in gestational diabetes: An emerging contender. Indian journal of endocrinology and metabolism, 19(2), 236–244. https://doi.org/10.4103/2230-8210.149317
Rowan, J. A., Rush, E. C., Plank, L. D., Lu, J., Obolonkin, V., Coat, S., & Hague, W. M. (2018). Metformin in gestational diabetes: the offspring follow-up (MiG TOFU): body composition and metabolic outcomes at 7-9 years of age. BMJ open diabetes research & care, 6(1), e000456. https://doi.org/10.1136/bmjdrc-2017-000456
Landi, S. N., Radke, S., Engel, S. M., Boggess, K., Stürmer, T., Howe, A. S., & Funk, M. J. (2019). Association of Long-term Child Growth and Developmental Outcomes With Metformin vs Insulin Treatment for Gestational Diabetes. JAMA pediatrics, 173(2), 160–168. https://doi.org/10.1001
How to Cite
Copyright (c) 2022 Magdalena Grześk-Kaczyńska, Magdalena Ostrowska, Dominika Pałac, Szymon Kaczyński
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Number of views and downloads: 193
Number of citations: 0