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| Risk factors and the risk prediction of gestational diabetes mellitus after pregnancy, in women with polycystic ovary syndrome and their pregnancy outcomes |
| The Third People's Hospital of Chengdu, Chengdu, Sichuan Province, 610000 |
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Abstract To analyze the risk predictors of gestational diabetes mellitus (GDM) of women with polycystic ovary syndrome (PCOS) after pregnancy, and to study the pregnancy outcomes of the women. Methods: The clinical data of 104 women with PCOS who had been pregnancy and had delivered successfully after standardized treatment in hospital from June 2020 to June 2023 were selected in this study retrospectively. These women were divided into group A (31 women with GDM) and group B (73 women without GDM) according to whether the GDM occurrence or not of the women. The clinical data of the women were compared between the two groups. Multivariate logistic regression analysis was conducted to identify the influencing factors of the GDM of the pregnant women with PCOS. Receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of the different factors of the women for their PCOS complicated with GDM. The pregnancy outcomes and the neonatal outcomes of the women were compared between the two groups. Results: The prepregnancy body mass index (BMI), the weight gain during pregnancy, the value of homeostasis model assessment of insulin resistance (HOMA-IR) and the level of fasting insulin (FINS) of the women in group A were 25.48±2.06kg/m2, 28.79±1.55kg, 4.28±0.63 and 19.66±3.45μU/ml, respectively, and which were significantly higher than those (23.30±1.98kg/m2, 6.73±1.14kg, 2.01±0.44 and 14.49±2.16μU/ml) of the women in group B (all P<0.05). Multivariate logistic regression analysis showed that the higher pre-pregnancy BMI, the more weight gain during pregnancy, the higher HOMA-IR value and FINS level of the women with PCOS were the independent risk factors of their GDM occurrence (P<0.05). ROC curve analysis showed that the area under the curve and the sensitivity of the combined pre-pregnancy BMI, the gestational weight gain, the HOMA-IR value and the FINS level of the pregnant women with PCOS for predicting their GDM were 0.893 and 93.6%, and the predictive efficiency of which were significantly higher than those of the pre-pregnancy BMI, the gestational weight gain, the HOMA-IR value or the FINS level alone (P<0.05). The incidences of gestational hypertension, preeclampsia, premature rupture of membranes and postpartum hemorrhage of the women in group A were 32.3%, 25.8%, 59.0% and 22.6%, respectively, and which were significantly higher than those (13.7%, 9.6%, 12.3% and 8.2%) of the women in group B. The incidence of neonatal hypoglycemia (22.6%) in group A was significantly higher than that (8.2%) in group B (all P<0.05). Conclusion: The high pre-pregnancy BMI, the more gestational weight gain, the elevated HOMA-IR value and FINS level of the pregnant women with PCOS all can cause their GDM occurrence. The pregnant women with PCOS and GDM can increase the incidence of their adverse pregnancy outcomes.
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