Objective: To estimate whether women with polycystic ovary syndrome (PCOS) will display ambient hyperglycemia (as measured by continuous glucose monitoring) early in pregnancy that progressively exacerbates with advancing pregnancy. Methods: This was a case-control study during singleton pregnancies of 17 women with PCOS and 17 healthy women. A 75-g oral glucose tolerance test (OGTT) followed by 24-hour continuous glucose monitoring was obtained four times throughout the pregnancy (visit 1: 6-10 weeks; visit 2: 12-16 weeks; visit 3: 24-28 weeks; visit 4: 34-38 weeks). Results: Eight women with PCOS (47%) and two women in the control group (12%) developed gestational diabetes mellitus (GDM) as defined by World Health Organization criteria. Women with PCOS had a higher area under the curve for glucose during the OGTT at visit 1, visit 2, and visit 3, and for insulin at visit 1, compared with the control group. No differences were found between groups for any of the continuous glucose monitoring parameters studied. The free androgen index significantly decreased over the course of the study in both groups with a stronger decrease in the PCOS group at visit 1 (P=.003), visit 2 (P=.07), and visit 3 (P=.04). The difference in birth weight between groups was not significant: 3,346 g in women with PCOS and 3,633 g in women in the control group, and there was no perinatal morbidity. Conclusion: Women with PCOS are at increased risk for GDM, which manifests early in pregnancy and is detectable by OGTT. Serial 24-hour glucose monitoring did not reveal changes in glucose metabolism, although our sample size was small. Hyperandrogenemia improves with progressive pregnancy in women with PCOS.
All Science Journal Classification (ASJC) codes
- Obstetrics and Gynecology