Prevalence of polycystic ovary syndrome (PCOS) among postpartum women with diabetes mellitus during pregnancy - preliminary report

Abstract

BACKGROUND: PCOS is closely linked with insulin resistance and type 2 diabetes mellitus. OBJECTIVE: To determine the prevalence of PCOS in post partum women managed for diabetes in pregnancy. METHOD & DESIGN: Cross sectional observational study. RECRUITMENT: 278 women with diabetes were recalled postpartum. We report the results of the first 57 (20.5 percent) subjects screened. OUTCOME MEASURES: Antenatal history, anthropometry, fasting blood sugar, plasma insulin, lipids, testosterone and transvaginal ultrasound scan for polycystic ovarian (PCO) morphology and volume. RESULTS: Statistics are presented as means ñ SE of continuous measures and frequency percentages for all discrete measures. Average post partum duration 40.51 ñ 1.76 weeks and age 34.25 ñ 0.68 years. Twenty-five (44 percent) had evidence of PCO with an ovarian volume of 14.11 ñ 3.87cm3 versus 3.63 ñ 0./6 cm3 in those with normal ovaries (p< 0.05). PCO vs. non-PCO Pre-pregnant menstrual irregularities 24 percent (6/25) vs. 9.4 percent (3/32), hirsutism 24 percent (6/25) vs. 9.4 percent (3/32), and subfertility 24 percent(6/25) vs. 15.6 percent (5/32) (NS). Insulin therapy in pregnancy 80 percent (20/25) vs. 53.1 percent (17/ 32) (p<0.05). BMI 25.36 ñ 0.52 vs. 23.25 ñ 0.54 kg/m2 (p< 0.01). Waist-hip ratio, systolic and diastolic blood pressures were greater in the PCO group. FBS, insulin, insulin sensitivity, testosterone and lipids were not significantly different between PCO and non-PCO. IMPRESSION: The prevalence of polycystic ovaries is high among post partum women who had diabetes during pregnancy, although their metabolic profile appears to be similar to women with normal ovarian morphology. A larger sample including controls is awaited. FUNDING: Association of Physicians of Great Britain & Ireland & Special Trustees, General Infirmary at Leeds UK.