Gestational Diabetes and Type 2 Diabetes in Reproductive-Aged Women With Polycystic Ovary Syndrome

Abstract

Context: Polycystic ovary syndrome (PCOS) affects 6%–21% of women. PCOS has been associated with an increased risk of dysglycemia including gestational diabetes mellitus (GDM) and type 2 diabetes mellitus (T2DM). Objective: The objective of the study was to assess the prevalence of dysglycemia and the impact of obesity in young reproductive-aged women with and without PCOS in a community-based cohort. Design: This was a cross-sectional analysis of data from a large longitudinal study (the Australian Longitudinal Study on Women's Health). Setting: The setting for the study was the general community. Participants: Women were randomly selected from the national health insurance database. Standardized data collection occurred at five survey time points (years 1996, 2000, 2003, 2006, and 2009). Data from survey 4 (2006, n = 9145, 62% of original cohort aged 18–23 y) were examined for this study. Main Outcome Measures: Self-reported PCOS, GDM, and T2DM were measured. Results: In women aged 28–33 years, PCOS prevalence was 5.8% [95% confidence interval (CI) 5.3%–6.4%]. The prevalence of GDM (in women reporting prior pregnancy) and T2DM was 11.2% and 5.1% in women with PCOS and 3.8% and 0.3% in women without PCOS, respectively (P for both < .001). PCOS was associated with an increased odds of GDM and T2DM. After adjusting for age, body mass index, hypertension, smoking, and demographic factors, the odds of GDM (odds ratio 2.1, 95% CI 1.1–3.9, P = .02) and T2DM (odds ratio 8.8, 95% CI 3.9–20.1, P < .001) remained increased in women reporting PCOS. Conclusions: In a large community-based cohort of reproductive-aged women, PCOS was independently associated with a higher risk of GDM and T2DM, independent of body mass index. Aggressive screening, prevention, and management of dysglycemia is clearly warranted in women with PCOS.