Adverse Effects of Polycystic Ovary Syndrome on Pregnancy Outcomes in Women with Gestational Diabetes Mellitus: A Retrospective Study

Background: Polycystic ovary syndrome (PCOS) and gestational diabetes mellitus (GDM) can both contribute to adverse maternal and neonatal outcomes. There is relatively limited research on the outcomes for women who have a history of both PCOS and GDM. Our study attempt to explore how the presence of comorbid PCOS affects pregnancy outcomes in women with GDM. Methods: Our study was a retrospective study of women diagnosed with GDM through a 75 g oral glucose tolerance test (OGTT) at our hospital from January 1, 2021, to December 31, 2022. We divided the participants into two groups, group +GDM/+PCOS and group +GDM/-PCOS, based on their history of PCOS. We compared clinical variables, delivery details and neonatal complications between the two groups. Results: Among the 149 women enrolled in the study with GDM, a total of 44 women were diagnosed with PCOS. Women with GDM and PCOS have higher plasma glucose level at 120 minutes (PG120) level (9.17 mmol/L vs 8.59 mmol/L, p = 0.001). The incidence of postpartum hemorrhage is higher in women with history of GDM and PCOS (2.9% vs 22.7%, p < 0.01). On regression analysis, plasma glucose level at 60 minutes (PG60) level (odds ratio (OR) 6.341, 95% confidence interval (CI) 1.69~23.76, p = 0.006) and PCOS (OR 36.105, 95% CI 3.89~335, p = 0.002) were identified as independent risk factors for postpartum hemorrhage. We also found that infants born to mothers with PCOS and GDM had lower Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) scores at 1 minute after birth (p < 0.01). PCOS was also an independent risk factor for lower 1-minute APGAR scores on regression analysis (β = –0.296, t = –3.852, p < 0.001). Conclusions: Women who co-presented with GDM and PCOS had worse postprandial blood glucose levels, higher rates of postpartum hemorrhage, and lower 1-minute APGAR scores in newborns. The management of PCOS should be promptly initiated, with close monitoring of blood glucose levels throughout pregnancy, and timely implementation of intervention measures to optimize obstetric and neonatal outcomes.