Abstract

EVAULATION OF OBSTETRIC & NEONATAL OUTCOMES IN “PCOS” WITH GESTATIONAL DIABETES MELLITUS (GDM)

Dr. U. Agnes Vijaya, Purushothama Reddy. K*, Dr. Anusha Patel, M. Srinivasullu, Mallesh. M

ABSTRACT

Background: Polycystic ovary syndrome (PCOS) is a common heterogeneous endocrine disorder characterized by irregular menses, hyperandrogenism & polycystic ovaries. The incidence varies between 0.5 – 4 % more common amongst infertile women. It is prevalent in young reproductive age group (20 – 30 %). Risk factor for PCOS in adults includes type II diabetes and gestational diabetes. Insulin resistance affects 50% –70% of women with PCOS leading to a number of comorbidities including metabolic syndrome, hypertension, dyslipidemia, glucose intolerance & diabetes. Objective: There are some metabolic similarities between women with gestational diabetes mellitus (GDM) and polycystic ovary syndrome (PCOS); it is still uncertain, however, to what extent coexistence GDM and PCOS affects pregnancy outcome. The present study was designed to determine the obstetric and neonatal outcome in PCOS with GDM. Materials and methods: A case-control study was conducted at RIMS Kadapa during 2013 – 2014 by involving 261 GDM women. 301 cases had PCOS based on Rotterdam criteria and the other 300 cases (control group) were women without PCOS. The subjects in each group were evaluated regarding obstetric and those women whose documentation’s were complete entered the study. Results: In present study, women with PCOS and GDM had more than 2 - fold increased odds of preeclampsia (p = 0.003, CI = 1.56 – 5.01 and OR = 2.8) and PIH (p= 0.04, CI = 1.28 – 4.5 and OR= 2.4). Maternal PCOS and GDM were also associated with 3 - fold increased odds of neonatal hypoglycemia (p= 0.004, CI= 1.49 – 6.58 and OR= 3.13). Conclusion: Our finding emphasized that pregnant PCOS patients should be followed carefully for the occurrence of various pregnancy and neonatal complications including hypertension and hypoglycemia. We suggested that these neonates should be given more care regarding hypoglycemia symptoms.

Keywords: Polycystic Ovarian Syndrome (PCOS), Gestational Diabetes Mellitus (GDM), Pregnancy outcome, Preeclampsia, Hypoglycemia.