Effect of preconception impaired glucose tolerance on pregnancy outcomes in women with polycystic ovary syndrome

Daimin Wei, Bo Zhang, Yuhua Shi, Lin Zhang, Shigang Zhao, Yanzhi Du, Lizhen Xu, Richard Legro, Heping Zhang, Zi Jiang Chen

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Context: Women with polycystic ovary syndrome (PCOS) commonly have intrinsic insulin resistance and are recommended to undergo an oral glucose tolerance test (OGTT) for diabetes screening. However, the effect of preconception impaired glucose tolerance (IGT) on pregnancy is still unclear. Objective: To prospectively assess the effect of preconception IGT on pregnancy outcomes. Design, Setting, Patients, Interventions, and Main Outcome Measures: This was a secondary analysis of a multicenter randomized trial in 1508 women with PCOS comparing live birth and obstetric complications between fresh and frozen embryo transfer. At baseline, fasting and 2-hour glucose and insulin levels after 75-g OGTT were measured. Results: Women with preconception IGT had higher risks of gestational diabetes in both singleton pregnancy [9.5% vs 3.2%; odds ratio (OR) 3.13; 95% confidence interval (CI) 1.23to 7.69] and twin pregnancy (20.0% vs 3.2%; OR 7.69; 95% CI 2.78 to 20.00) than women with normoglycemia. Preconception IGT was associated with a higher risk of large for gestational age in singleton newborns compared with normoglycemia (34.7% vs 19.8%; OR 2.13; 95% CI 1.19 to 3.85) or isolated impaired fasting glucose (i-IFG) (34.7% vs 15.4%; OR 2.94; 95% CI 1.33 to 6.25). Women with preconception IGT had a higher singleton pregnancy loss rate than women with i-IFG (31.4% vs 17.5%; OR 2.17; 95% CI 1.11 to 4.17). After adjusting for age, body mass index, duration of infertility, total testosterone level, and treatment groups (frozen vs fresh embryo transfer), these associations remained. Conclusions: Preconception IGT, independent from BMI, was associated with adverse pregnancy outcome compared with i-IFG and normoglycemia.

Original languageEnglish (US)
Pages (from-to)3822-3829
Number of pages8
JournalJournal of Clinical Endocrinology and Metabolism
Volume102
Issue number10
DOIs
StatePublished - Oct 1 2017

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Glucose Intolerance
Polycystic Ovary Syndrome
Pregnancy Outcome
Glucose
Odds Ratio
Confidence Intervals
Fasting
Embryo Transfer
Glucose Tolerance Test
Pregnancy
Twin Pregnancy
Gestational Diabetes
Live Birth
Pregnancy Rate
Medical problems
Infertility
Gestational Age
Obstetrics
Multicenter Studies
Insulin Resistance

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Wei, Daimin ; Zhang, Bo ; Shi, Yuhua ; Zhang, Lin ; Zhao, Shigang ; Du, Yanzhi ; Xu, Lizhen ; Legro, Richard ; Zhang, Heping ; Chen, Zi Jiang. / Effect of preconception impaired glucose tolerance on pregnancy outcomes in women with polycystic ovary syndrome. In: Journal of Clinical Endocrinology and Metabolism. 2017 ; Vol. 102, No. 10. pp. 3822-3829.
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abstract = "Context: Women with polycystic ovary syndrome (PCOS) commonly have intrinsic insulin resistance and are recommended to undergo an oral glucose tolerance test (OGTT) for diabetes screening. However, the effect of preconception impaired glucose tolerance (IGT) on pregnancy is still unclear. Objective: To prospectively assess the effect of preconception IGT on pregnancy outcomes. Design, Setting, Patients, Interventions, and Main Outcome Measures: This was a secondary analysis of a multicenter randomized trial in 1508 women with PCOS comparing live birth and obstetric complications between fresh and frozen embryo transfer. At baseline, fasting and 2-hour glucose and insulin levels after 75-g OGTT were measured. Results: Women with preconception IGT had higher risks of gestational diabetes in both singleton pregnancy [9.5{\%} vs 3.2{\%}; odds ratio (OR) 3.13; 95{\%} confidence interval (CI) 1.23to 7.69] and twin pregnancy (20.0{\%} vs 3.2{\%}; OR 7.69; 95{\%} CI 2.78 to 20.00) than women with normoglycemia. Preconception IGT was associated with a higher risk of large for gestational age in singleton newborns compared with normoglycemia (34.7{\%} vs 19.8{\%}; OR 2.13; 95{\%} CI 1.19 to 3.85) or isolated impaired fasting glucose (i-IFG) (34.7{\%} vs 15.4{\%}; OR 2.94; 95{\%} CI 1.33 to 6.25). Women with preconception IGT had a higher singleton pregnancy loss rate than women with i-IFG (31.4{\%} vs 17.5{\%}; OR 2.17; 95{\%} CI 1.11 to 4.17). After adjusting for age, body mass index, duration of infertility, total testosterone level, and treatment groups (frozen vs fresh embryo transfer), these associations remained. Conclusions: Preconception IGT, independent from BMI, was associated with adverse pregnancy outcome compared with i-IFG and normoglycemia.",
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Effect of preconception impaired glucose tolerance on pregnancy outcomes in women with polycystic ovary syndrome. / Wei, Daimin; Zhang, Bo; Shi, Yuhua; Zhang, Lin; Zhao, Shigang; Du, Yanzhi; Xu, Lizhen; Legro, Richard; Zhang, Heping; Chen, Zi Jiang.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 102, No. 10, 01.10.2017, p. 3822-3829.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effect of preconception impaired glucose tolerance on pregnancy outcomes in women with polycystic ovary syndrome

AU - Wei, Daimin

AU - Zhang, Bo

AU - Shi, Yuhua

AU - Zhang, Lin

AU - Zhao, Shigang

AU - Du, Yanzhi

AU - Xu, Lizhen

AU - Legro, Richard

AU - Zhang, Heping

AU - Chen, Zi Jiang

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Context: Women with polycystic ovary syndrome (PCOS) commonly have intrinsic insulin resistance and are recommended to undergo an oral glucose tolerance test (OGTT) for diabetes screening. However, the effect of preconception impaired glucose tolerance (IGT) on pregnancy is still unclear. Objective: To prospectively assess the effect of preconception IGT on pregnancy outcomes. Design, Setting, Patients, Interventions, and Main Outcome Measures: This was a secondary analysis of a multicenter randomized trial in 1508 women with PCOS comparing live birth and obstetric complications between fresh and frozen embryo transfer. At baseline, fasting and 2-hour glucose and insulin levels after 75-g OGTT were measured. Results: Women with preconception IGT had higher risks of gestational diabetes in both singleton pregnancy [9.5% vs 3.2%; odds ratio (OR) 3.13; 95% confidence interval (CI) 1.23to 7.69] and twin pregnancy (20.0% vs 3.2%; OR 7.69; 95% CI 2.78 to 20.00) than women with normoglycemia. Preconception IGT was associated with a higher risk of large for gestational age in singleton newborns compared with normoglycemia (34.7% vs 19.8%; OR 2.13; 95% CI 1.19 to 3.85) or isolated impaired fasting glucose (i-IFG) (34.7% vs 15.4%; OR 2.94; 95% CI 1.33 to 6.25). Women with preconception IGT had a higher singleton pregnancy loss rate than women with i-IFG (31.4% vs 17.5%; OR 2.17; 95% CI 1.11 to 4.17). After adjusting for age, body mass index, duration of infertility, total testosterone level, and treatment groups (frozen vs fresh embryo transfer), these associations remained. Conclusions: Preconception IGT, independent from BMI, was associated with adverse pregnancy outcome compared with i-IFG and normoglycemia.

AB - Context: Women with polycystic ovary syndrome (PCOS) commonly have intrinsic insulin resistance and are recommended to undergo an oral glucose tolerance test (OGTT) for diabetes screening. However, the effect of preconception impaired glucose tolerance (IGT) on pregnancy is still unclear. Objective: To prospectively assess the effect of preconception IGT on pregnancy outcomes. Design, Setting, Patients, Interventions, and Main Outcome Measures: This was a secondary analysis of a multicenter randomized trial in 1508 women with PCOS comparing live birth and obstetric complications between fresh and frozen embryo transfer. At baseline, fasting and 2-hour glucose and insulin levels after 75-g OGTT were measured. Results: Women with preconception IGT had higher risks of gestational diabetes in both singleton pregnancy [9.5% vs 3.2%; odds ratio (OR) 3.13; 95% confidence interval (CI) 1.23to 7.69] and twin pregnancy (20.0% vs 3.2%; OR 7.69; 95% CI 2.78 to 20.00) than women with normoglycemia. Preconception IGT was associated with a higher risk of large for gestational age in singleton newborns compared with normoglycemia (34.7% vs 19.8%; OR 2.13; 95% CI 1.19 to 3.85) or isolated impaired fasting glucose (i-IFG) (34.7% vs 15.4%; OR 2.94; 95% CI 1.33 to 6.25). Women with preconception IGT had a higher singleton pregnancy loss rate than women with i-IFG (31.4% vs 17.5%; OR 2.17; 95% CI 1.11 to 4.17). After adjusting for age, body mass index, duration of infertility, total testosterone level, and treatment groups (frozen vs fresh embryo transfer), these associations remained. Conclusions: Preconception IGT, independent from BMI, was associated with adverse pregnancy outcome compared with i-IFG and normoglycemia.

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