 Women
with PCOS (Polycystic Ovarian Syndrome) who
become pregnant may experience more health problems than the
general population, including gestational diabetes,
pregnancy-induced high blood pressure, miscarriage and premature
delivery (1). Researchers have also documented health issues
such as pre-eclampsia,
macrosomia, (babies bigger than 4,500 grams at birth) and
clotting factors in pregnant women with PCOS (2).
All of these serious problems are yet more evidence that it is
extremely important to address PCOS and make the lifestyle
changes necessary to reverse it and the underlying cause of
Insulin Resistance. This is vital to prevent the health issues
that can compromise long term wellness for both mother and child
during and after pregnancy.
Gestational Diabetes
Pregnant women who have never had diabetes may experience high
blood sugar levels during pregnancy, which is also known as
gestational diabetes. This complication affects about four
percent of all pregnant women. Studies have shown that women who
have been diagnosed in pregnancy with gestational diabetes are
found to have a higher prevalence of PCOS on subsequent
screening (3). The risk is believed to be greater in obese women
with PCOS who require ovulation induction in order to conceive.
Ovulation induction is a procedure in which women who are
infertile are treated with medication to stimulate the
development of mature follicles in their ovaries to facilitate
the growth of eggs.
Women who have been diagnosed as having PCOS before pregnancy
should be screened for gestational diabetes in early pregnancy,
with referral to a specialized obstetric diabetic service if
abnormalities are detected. Such patients should be screened for
abnormal glucose tolerance in pregnancy and, if appropriate,
referred for antenatal management by an obstetrician with
special interest in pregnancy and diabetes.
 Pregnancy-induced High Blood Pressure
Some studies have demonstrated that there is a higher risk of
pregnancy-induced high blood pressure among patients with PCOS
(4). However, other studies showed no relationship between PCOS
and the development of hypertension during pregnancy. A woman
with borderline hypertension before pregnancy is more likely to
have increased blood pressure in pregnancy, but most doctors
check all patients for blood pressure issues. Women with PCOS
should ensure that their physicians document their blood
pressure throughout the pregnancy.
Miscarriage and Insulin Resistance
Women who have PCOS and are successful at becoming pregnant
typically experience a higher rate of miscarriage than those who
don’t have PCOS. Some studies put the rate of miscarriage for
women with PCOS at 45 percent, as compared to the national
average of 15 percent (5). PCOS is a syndrome of hormone
imbalances; women who suffer from it have some hormones at too
high of levels while others are too low.
In a pregnant woman with PCOS, elevated levels of insulin may
interfere with the normal balance between factors promoting
blood clotting and those promoting the breakdown of the clots.
High insulin levels may actually result in increased blood
clotting at the interface between the uterine lining and the
placenta, leading to placental insufficiency, which is the
failure of the placenta to supply nutrients to the fetus and
remove toxic wastes. The result is miscarriage (6).
Premature Delivery
PCOS is associated with a 30 to 40 percent rate of early
pregnancy loss (EPL), defined as miscarriage during the first
trimester. In most cases no apparent cause can be identified
but, in addition to defects in the developing embryo, adverse
alterations in endometrial function may play a role. Insulin
dysfunction has been identified as an independent risk factor
for EPL. Studies in PCOS suggest that hyperinsulinemia
suppresses endometrial expression of glycodelin, a protein whose
circulating concentration may reflect endometrial function.
Glycodelin is secreted by the endometrium and may inhibit the
endometrial immune response to the embryo, and likely plays a
critical role during implantation and in the maintenance of
pregnancy (7).
Pre-eclampsia and Macrosomia
Pre-eclampsia is a dangerous complication of pregnancy, involving
high blood pressure, protein traces in the urine and edema
(abnormal fluid accumulation in parts of the body). It is one of
the most dangerous complications that can occur during pregnancy
and is a major cause of both maternal and child death during
pregnancy and immediately after birth. Macrosomia is the
term for a newborn with an excessive birth weight. Factors
associated with fetal macrosomia include gestational diabetes
and Diabetes Mellitus, demonstrating once again a link to
hormonal disorder (8).
Promoting a Healthy Pregnancy
You can take certain steps to improve your overall health that
may also be helpful in ensuring a healthy and complication-free
pregnancy in the future. These steps include improving your
overall diet, increasing your exercise, reducing your stress
levels and balancing your hormonal systems. The Insulite PCOS
System incorporates all of these approaches to treat PCOS and
its underlying Insulin Resistance, which can be helpful in
reducing any health risks during pregnancy.
Because there is no single solution that addresses all the
symptoms of Polycystic Ovarian Syndrome or Insulin Resistance,
you must rely on a multi-faceted approach to reversing these
conditions. A complete system, including nutraceuticals
(vitamins, herbs and minerals that are disease specific), a
realistic exercise program, nutritional guidance and a support
network that will help you change unhealthy lifestyle choices,
will address the issues presented by these syndromes. Treatment
of your PCOS may help increase your chances of conceiving and
having a healthy pregnancy.
You may be interested in some of our Frequently Asked Questions
(FAQs) on infertility, pregnancy and the Insulite PCOS
System..
(1)
The National Women’s Health Information Center - http://www.4woman.gov/faq/pcos.htm
(2) PCOSA Newsletter - June 2005, Volume 8, Issue 1, p.9.
(3)
Long Term Consequences of Polycystic Ovarian Syndrome
- Samir F. Abdel Aziz, MD, Obstetrics and Gynecology, Al-Azhar University.
(4) Ibid.
(5)
PCOSA Newsletter - June 2005, Volume 8, Issue 1, p.9.
(6)
Miscarriage and PCOS - Georgia Reproductive Specialists, IVF.com, 2005
(7) Viewpoints on Polycystic Ovary Syndrome
- Viewpoints on Polycystic Ovary Syndrome
(8) "Macrosomia." - EMedicine.com, 2005
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