Pregnancy Complications Associated With PCOS

Risks to Mom and Baby and How You Might Prevent Them

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Most women with PCOS are aware that they may have some difficulty becoming pregnant. Irregular periods and absent ovulation can make it challenging to time intercourse for pregnancy and commonly leads a couple to seek out the assistance of a reproductive specialist.

Woman talking to a doctor in her office
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But many women aren’t aware that having PCOS can also increase their risk for certain pregnancy-related complications like those covered here.

Rest assured, visiting your obstetrician regularly and following their recommendations for prenatal screening can help reduce your risk of many of these complications.

Miscarriage

Women who have PCOS do appear to be at a slightly higher risk for having a miscarriage, though the cause for this relationship is unclear. Researchers believe that a few factors may be to blame.

First, women with PCOS tend to have longer menstrual cycles, meaning that ovulation occurs later on. This exposes the developing egg to lots of hormones, possibly damaging it.

Second, there is a known relationship between uncontrolled blood sugar and miscarriage. Given that women with PCOS tend to have insulin resistance and elevated insulin levels, some researchers hypothesize that this may contribute to poor egg quality and miscarriage.

High androgen levels and endometrial dysfunction, meaning problems with implantation, may also play a role in the increased risk of early pregnancy loss in women with PCOS. That said, more research is needed before a clear association can be developed.

Gestational Hypertension and Preeclampsia

Gestational hypertension refers to women who develop new-onset high blood pressure after 20 weeks. Preeclampsia is a serious health condition that also develops in the second half of pregnancy and causes protein in the urine, in addition to high blood pressure.

If left untreated, preeclampsia can progress to the severe form of the syndrome called eclampsia, which can cause seizures, blindness, and/or coma. In serious cases, both maternal and fetal death can result.

Every time you visit your healthcare provider, they will check your blood pressure and sometimes take a urine sample to look for protein in the urine. This is to make sure that you are not developing preeclampsia.

If you are diagnosed with preeclampsia, treatment may involve bed rest, frequent monitoring, and sometimes medication to lower your blood pressure. If your symptoms get worse, the only known cure is to deliver the baby. The goal is to get the baby as far along in the pregnancy as possible so that the lungs have a chance to develop.

Women with PCOS may be at greater risk for high blood pressure. If it's determined that you are at high risk, your healthcare provider may recommend low-dose aspirin (81 milligrams/day)—starting at 12 weeks of pregnancy—to help prevent preeclampsia and its related complications.

It's also important to watch out for signs and symptoms of gestational hypertension and preeclampsia (swelling, rapid weight gain, severe headache, vision changes) and promptly report them to your healthcare provider, or proceed to the emergency room if necessary.

Gestational Diabetes

Gestational diabetes occurs when diabetes, an alteration in how the body processes sugar, develops during pregnancy. While the condition usually resolves after giving birth, a woman with gestational diabetes is more likely to develop type 2 diabetes later in life, requiring ongoing monitoring of blood sugar levels.

All pregnant women are monitored for gestational diabetes with routine blood sugar screening sometime between 26 and 28 weeks. Women with known diabetes, insulin resistance, or who are at higher risk for developing gestational diabetes may be screened earlier.

Women who are older than 25, have had gestational diabetes with prior pregnancies, who are overweight, who have prediabetes, or who have close family members who have been diagnosed with type 2 diabetes are at greater risk for developing gestational diabetes. Women with PCOS are a part of that group because of the association with insulin resistance and prediabetes.

Gestational diabetes can be treated with a combination of lifestyle changes or medication if necessary. It's important to be vigilant about monitoring your blood sugar as directed by your healthcare provider because babies born to mothers with gestational diabetes are at higher risk for high birth weight, preterm birth, respiratory issues at birth, low blood sugar, and jaundice.

Premature Delivery

Women with PCOS are also at risk of delivering their baby early. The reason behind this again is not totally clear. Experts do know that preeclampsia is a risk factor for premature delivery, and women with PCOS are at a higher risk of preeclampsia.

In addition, experts have found that babies born to moms with PCOS are more likely to be large (called large for gestational age), have meconium aspiration (when a baby's first stool gets into their lungs), and have a low Apgar score at five minutes.

A Word From Verywell

Some of these complications sound pretty scary, but there are many things that you can do to help lower your risk.

First and foremost, get regular prenatal care as early into the pregnancy as possible. Even better would be to see your healthcare provider before trying to conceive so that you can discuss specific lifestyle strategies to lower your risks.

For instance, discuss an exercise regimen with your healthcare provider, and if you struggle with healthy eating habits, ask for a referral to a nutritionist.

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6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Diamanti-Kandarakis E, Dunaif A. Insulin resistance and the polycystic ovary syndrome revisited: an update on mechanisms and implications. Endocr Rev. 2012;33(6):981-1030. doi:10.1210/er.2011-1034

  3. Cleveland Clinic. Polycystic ovary syndrome (PCOS).

  4. U.S. Preventive Services Task Force. Aspirin use to prevent preeclampsia and related morbidity and mortality: U.S. Preventive Services Task Force recommendation statement.

  5. Centers for Disease Control and Prevention. Diabetes: who's at risk?

  6. Naver KV, Grinsted J, Larsen SO, et al. Increased risk of preterm delivery and pre-eclampsia in women with polycystic ovary syndrome and hyperandrogenaemia. BJOG. 2014;121(5):575-81. doi:10.1111/1471-0528.12558

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