4.5 Article

The risk factors of gestational diabetes mellitus in patients with polycystic ovary syndrome What should we care

Journal

MEDICINE
Volume 100, Issue 31, Pages -

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MD.0000000000026521

Keywords

care; gestational diabetes mellitus; management; PCOS; pregnancy

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The incidence of GDM in PCOS patients is high, with age, body mass index, insulin resistance index, testosterone, and other factors being independent risk factors for GDM. There are significant differences in complications between the GDM group and the no-GDM group.
The influencing factors of gestational diabetes mellitus (GDM) in the polycystic ovary syndrome (PCOS) patients remain unclear, we aimed to investigate the risk factors of GDM in patients with PCOS, to provide reliable evidence for the prevention and treatment of GDM in PCOS patients. PCOS patients treated in our hospital from January 1, 2019 to October 31, 2020 were included. The personal and clinical treatment details of GDM and no GDM patients were analyzed. Logistic regressions were performed to analyze the factors influencing the occurrence of GDM. A total of 196 PCOS patients were included, the incidence of GDM in patients with PCOS was 23.98%. There were significant differences in the age, body mass index, insulin resistance index, fasting insulin, testosterone, androstenedione, and sex hormone-binding protein between GDM and no GDM patients with PCOS (all P < .05), and no significant differences in the family history of GDM, the history of adverse pregnancy, and multiple pregnancies were found (all P > .05). Age >= 30 years (odds ratio (OR) 2.418, 95% confidence interval (CI) 1.181-3.784), body mass index >= 24 kg/m(2) (OR 1.973, 95%CI 1.266-3.121), insulin resistance index >= 22.69 (OR 2.491, 95%CI 1.193-4.043), fasting insulin >= 22.71 mIU/L (OR 2.508, 95%CI 1.166-5.057), testosterone >= 2.85 nmol/L (OR 1.821, 95%CI 1.104-2.762), androstenedione >= 6.63 nmol/L (OR 1.954, 95%CI 1.262-2.844), sex hormone-binding protein <64.22 nmol/L (OR 1.497, 95%CI 1.028-2.016) were the independent risk factors of GDM in patients with PCOS (all P < .05). The incidence of preeclampsia, premature delivery, premature rupture of membranes, polyhydramnios, and postpartum hemorrhage in the GDM group was significantly higher than that of the no-GDM group (all P < .05). There was no significant difference in the incidence of oligohydramnios between the 2 groups (P = .057). The incidence of GDM in PCOS patients is high, and the measures targeted at the risk factors are needed to reduce the occurrence of GDM in patients with PCOS.

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