Increased Prevalence of Gestational Diabetes Mellitus Among Women With Diagnosed Polycystic Ovary Syndrome

Abstract

Gestational diabetes mellitus (GDM), defined as carbohydrate intolerance at onset of pregnancy (or first recognition), affects ∼4–7% of pregnancies overall (1–6). Common risk factors include nonwhite race/ethnicity, older age, obesity, and prior GDM (3–7). Other conditions predisposing to glucose intolerance might also increase the risk of GDM. Polycystic ovary syndrome (PCOS) is a reproductive condition characterized by chronic anovulation, insulin resistance, and androgen excess (8–10). Affected women have an increased risk of glucose intolerance and type 2 diabetes (11–14). Some, but not all, studies suggest the risk of GDM is higher among PCOS versus non-PCOS women (15–18), and several studies note an increased prevalence of polycystic ovarian morphology and symptoms in women with prior GDM (19–21). This study examines the prevalence and association of PCOS and GDM among a large multiethnic population of pregnant women in northern California. Kaiser Permanente of Northern California (KPNC) is a large integrated health care delivery system providing comprehensive medical care for >3,000,000 members in northern California. There are 14 delivery hospitals with >30,000 births/year. Comprehensive health plan databases of all hospitalizations, ambulatory visits, and laboratory tests are available and linked by unique patient identifiers (22). This study was approved by the KPNC Institutional Review Board. As previously described (1), we used hospitalization databases to identify third trimester pregnancies between 1 January 2002 and 31 December 2004 …