The impact of maternal hyperandrogenism on pregnancy outcome in patients with polycystic ovary syndrome

XIE Yan-fen; XU Qiu-yi; LIU Jiao; WANG Hao; LI Li

doi:10.13820/j.cnki.gdyx.20242539

Abstract：Objective To investigate the impact of hyperandrogenemia on pregnancy outcomes in patients with polycystic ovary syndrome(PCOS).Methods This retrospective cohort study included clinical data from 462 PCOS pa-tients who were diagnosed and confirmed pregnant between 2017 and 2022 at the Guangdong Provincial Maternity and Child Care Center.Patients were divided into a hyperandrogenemia(HA)group(n=282)and a non-hyperandrogene-mia(NA)group(n=180)based on elevated pre-pregnancy serum androgen levels(testosterone≥1.96 nmol/L and/or androstenedione ≥ 10.8 nmol/L).Adverse pregnancy outcomes,including miscarriage,preterm birth,gestational dia-betes mellitus(GDM),hypertensive disorders of pregnancy(HIP),and fetal growth restriction(FGR),were compared between groups.Subgroup analysis was conducted by dividing the HA group into insulin resistance(IR)and non-insulin resistance(NIR)subgroups to further compare pregnancy outcomes.Results The miscarriage rate in the HA group was significantly higher than in the NA group(P＜0.05).No statistically significant differences were observed between the HA and NA groups in the rates of preterm birth,GDM,HIP,or FGR(P＞0.05).Within the HA group,the miscarriage rate was significantly higher in the IR subgroup compared to the NIR subgroup(P＜0.05),while rates of preterm birth,GDM,HIP,and FGR did not differ significantly between these subgroups(P＞0.05).Elevated androgens(OR=1.795,95％CI 1.177-2.738)and insulin resistance(OR=1.597,95％CI 1.011-2.522)were identified as independent risk factors for adverse pregnancy outcomes(P＜0.05).Conclusion Hyperandrogenemia and insulin resistance increase the risk of miscarriage in PCOS patients,highlighting the importance of managing these factors to improve pregnancy out-comes.