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Effect of Preconception Impaired Glucose Tolerance on Pregnancy Outcomes in Women With Polycystic Ovary Syndrome

Abstract Context Women with polycystic ovary syndrome (PCOS) commonly have intrinsic insulin resistance and are recommended to undergo an oral glucose tolerance test (OGTT) for diabetes screening. However, the effect of preconception impaired glucose tolerance (IGT) on pregnancy is still unclear. Ob... Full description

Journal Title: The journal of clinical endocrinology and metabolism 2017, Vol.102 (10), p.3822-3829
Main Author: Wei, Daimin
Other Authors: Zhang, Bo , Shi, Yuhua , Zhang, Lin , Zhao, Shigang , Du, Yanzhi , Xu, Lizhen , Legro, Richard S , Zhang, Heping , Chen, Zi-Jiang
Format: Electronic Article Electronic Article
Language: English
Subjects:
Age
Publisher: Washington, DC: Endocrine Society
ID: ISSN: 0021-972X
Link: https://www.ncbi.nlm.nih.gov/pubmed/28938429
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title: Effect of Preconception Impaired Glucose Tolerance on Pregnancy Outcomes in Women With Polycystic Ovary Syndrome
format: Article
creator:
  • Wei, Daimin
  • Zhang, Bo
  • Shi, Yuhua
  • Zhang, Lin
  • Zhao, Shigang
  • Du, Yanzhi
  • Xu, Lizhen
  • Legro, Richard S
  • Zhang, Heping
  • Chen, Zi-Jiang
subjects:
  • Abortion
  • Adult
  • Age
  • Body mass
  • Body mass index
  • Complications
  • Diabetes
  • Diabetes mellitus
  • Embryo transfer
  • Fasting
  • Female
  • Fertilization - physiology
  • Fertilization in Vitro
  • Gestational age
  • Glucose
  • Glucose Intolerance - blood
  • Glucose Intolerance - complications
  • Glucose Intolerance - epidemiology
  • Glucose tolerance
  • Glucose Tolerance Test
  • Health risks
  • Humans
  • Infant, Newborn
  • Infertility
  • Infertility, Female - blood
  • Infertility, Female - complications
  • Infertility, Female - epidemiology
  • Infertility, Female - therapy
  • Insulin
  • Laboratory testing
  • Male
  • Neonates
  • Polycystic ovary syndrome
  • Polycystic Ovary Syndrome - blood
  • Polycystic Ovary Syndrome - complications
  • Polycystic Ovary Syndrome - epidemiology
  • Pregnancy
  • Pregnancy complications
  • Pregnancy Complications - blood
  • Pregnancy Complications - epidemiology
  • Pregnancy Outcome - epidemiology
  • Pregnancy Rate
  • Risk factors
  • Secondary analysis
  • Sperm Injections, Intracytoplasmic
  • Testosterone
  • Young Adult
ispartof: The journal of clinical endocrinology and metabolism, 2017, Vol.102 (10), p.3822-3829
description: Abstract Context Women with polycystic ovary syndrome (PCOS) commonly have intrinsic insulin resistance and are recommended to undergo an oral glucose tolerance test (OGTT) for diabetes screening. However, the effect of preconception impaired glucose tolerance (IGT) on pregnancy is still unclear. Objective To prospectively assess the effect of preconception IGT on pregnancy outcomes. Design, Setting, Patients, Interventions, and Main Outcome Measures This was a secondary analysis of a multicenter randomized trial in 1508 women with PCOS comparing live birth and obstetric complications between fresh and frozen embryo transfer. At baseline, fasting and 2-hour glucose and insulin levels after 75-g OGTT were measured. Results Women with preconception IGT had higher risks of gestational diabetes in both singleton pregnancy [9.5% vs 3.2%; odds ratio (OR) 3.13; 95% confidence interval (CI) 1.23to 7.69] and twin pregnancy (20.0% vs 3.2%; OR 7.69; 95% CI 2.78 to 20.00) than women with normoglycemia. Preconception IGT was associated with a higher risk of large for gestational age in singleton newborns compared with normoglycemia (34.7% vs 19.8%; OR 2.13; 95% CI 1.19 to 3.85) or isolated impaired fasting glucose (i-IFG) (34.7% vs 15.4%; OR 2.94; 95% CI 1.33 to 6.25). Women with preconception IGT had a higher singleton pregnancy loss rate than women with i-IFG (31.4% vs 17.5%; OR 2.17; 95% CI 1.11 to 4.17). After adjusting for age, body mass index, duration of infertility, total testosterone level, and treatment groups (frozen vs fresh embryo transfer), these associations remained. Conclusions Preconception IGT, independent from BMI, was associated with adverse pregnancy outcome compared with i-IFG and normoglycemia. Preconception IGT independent from obesity was associated with increased risks of singleton pregnancy loss, gestational diabetes, and large for gestational age in women with PCOS.
language: eng
source:
identifier: ISSN: 0021-972X
fulltext: no_fulltext
issn:
  • 0021-972X
  • 1945-7197
url: Link


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titleEffect of Preconception Impaired Glucose Tolerance on Pregnancy Outcomes in Women With Polycystic Ovary Syndrome
creatorWei, Daimin ; Zhang, Bo ; Shi, Yuhua ; Zhang, Lin ; Zhao, Shigang ; Du, Yanzhi ; Xu, Lizhen ; Legro, Richard S ; Zhang, Heping ; Chen, Zi-Jiang
creatorcontribWei, Daimin ; Zhang, Bo ; Shi, Yuhua ; Zhang, Lin ; Zhao, Shigang ; Du, Yanzhi ; Xu, Lizhen ; Legro, Richard S ; Zhang, Heping ; Chen, Zi-Jiang
descriptionAbstract Context Women with polycystic ovary syndrome (PCOS) commonly have intrinsic insulin resistance and are recommended to undergo an oral glucose tolerance test (OGTT) for diabetes screening. However, the effect of preconception impaired glucose tolerance (IGT) on pregnancy is still unclear. Objective To prospectively assess the effect of preconception IGT on pregnancy outcomes. Design, Setting, Patients, Interventions, and Main Outcome Measures This was a secondary analysis of a multicenter randomized trial in 1508 women with PCOS comparing live birth and obstetric complications between fresh and frozen embryo transfer. At baseline, fasting and 2-hour glucose and insulin levels after 75-g OGTT were measured. Results Women with preconception IGT had higher risks of gestational diabetes in both singleton pregnancy [9.5% vs 3.2%; odds ratio (OR) 3.13; 95% confidence interval (CI) 1.23to 7.69] and twin pregnancy (20.0% vs 3.2%; OR 7.69; 95% CI 2.78 to 20.00) than women with normoglycemia. Preconception IGT was associated with a higher risk of large for gestational age in singleton newborns compared with normoglycemia (34.7% vs 19.8%; OR 2.13; 95% CI 1.19 to 3.85) or isolated impaired fasting glucose (i-IFG) (34.7% vs 15.4%; OR 2.94; 95% CI 1.33 to 6.25). Women with preconception IGT had a higher singleton pregnancy loss rate than women with i-IFG (31.4% vs 17.5%; OR 2.17; 95% CI 1.11 to 4.17). After adjusting for age, body mass index, duration of infertility, total testosterone level, and treatment groups (frozen vs fresh embryo transfer), these associations remained. Conclusions Preconception IGT, independent from BMI, was associated with adverse pregnancy outcome compared with i-IFG and normoglycemia. Preconception IGT independent from obesity was associated with increased risks of singleton pregnancy loss, gestational diabetes, and large for gestational age in women with PCOS.
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2DOI: 10.1210/jc.2017-01294
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languageeng
publisherWashington, DC: Endocrine Society
subjectAbortion ; Adult ; Age ; Body mass ; Body mass index ; Complications ; Diabetes ; Diabetes mellitus ; Embryo transfer ; Fasting ; Female ; Fertilization - physiology ; Fertilization in Vitro ; Gestational age ; Glucose ; Glucose Intolerance - blood ; Glucose Intolerance - complications ; Glucose Intolerance - epidemiology ; Glucose tolerance ; Glucose Tolerance Test ; Health risks ; Humans ; Infant, Newborn ; Infertility ; Infertility, Female - blood ; Infertility, Female - complications ; Infertility, Female - epidemiology ; Infertility, Female - therapy ; Insulin ; Laboratory testing ; Male ; Neonates ; Polycystic ovary syndrome ; Polycystic Ovary Syndrome - blood ; Polycystic Ovary Syndrome - complications ; Polycystic Ovary Syndrome - epidemiology ; Pregnancy ; Pregnancy complications ; Pregnancy Complications - blood ; Pregnancy Complications - epidemiology ; Pregnancy Outcome - epidemiology ; Pregnancy Rate ; Risk factors ; Secondary analysis ; Sperm Injections, Intracytoplasmic ; Testosterone ; Young Adult
ispartofThe journal of clinical endocrinology and metabolism, 2017, Vol.102 (10), p.3822-3829
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0Copyright © 2017 Endocrine Society 2017
1Copyright © Oxford University Press 2015
2Copyright © 2017 Endocrine Society
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0Wei, Daimin
1Zhang, Bo
2Shi, Yuhua
3Zhang, Lin
4Zhao, Shigang
5Du, Yanzhi
6Xu, Lizhen
7Legro, Richard S
8Zhang, Heping
9Chen, Zi-Jiang
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0Effect of Preconception Impaired Glucose Tolerance on Pregnancy Outcomes in Women With Polycystic Ovary Syndrome
1The journal of clinical endocrinology and metabolism
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descriptionAbstract Context Women with polycystic ovary syndrome (PCOS) commonly have intrinsic insulin resistance and are recommended to undergo an oral glucose tolerance test (OGTT) for diabetes screening. However, the effect of preconception impaired glucose tolerance (IGT) on pregnancy is still unclear. Objective To prospectively assess the effect of preconception IGT on pregnancy outcomes. Design, Setting, Patients, Interventions, and Main Outcome Measures This was a secondary analysis of a multicenter randomized trial in 1508 women with PCOS comparing live birth and obstetric complications between fresh and frozen embryo transfer. At baseline, fasting and 2-hour glucose and insulin levels after 75-g OGTT were measured. Results Women with preconception IGT had higher risks of gestational diabetes in both singleton pregnancy [9.5% vs 3.2%; odds ratio (OR) 3.13; 95% confidence interval (CI) 1.23to 7.69] and twin pregnancy (20.0% vs 3.2%; OR 7.69; 95% CI 2.78 to 20.00) than women with normoglycemia. Preconception IGT was associated with a higher risk of large for gestational age in singleton newborns compared with normoglycemia (34.7% vs 19.8%; OR 2.13; 95% CI 1.19 to 3.85) or isolated impaired fasting glucose (i-IFG) (34.7% vs 15.4%; OR 2.94; 95% CI 1.33 to 6.25). Women with preconception IGT had a higher singleton pregnancy loss rate than women with i-IFG (31.4% vs 17.5%; OR 2.17; 95% CI 1.11 to 4.17). After adjusting for age, body mass index, duration of infertility, total testosterone level, and treatment groups (frozen vs fresh embryo transfer), these associations remained. Conclusions Preconception IGT, independent from BMI, was associated with adverse pregnancy outcome compared with i-IFG and normoglycemia. Preconception IGT independent from obesity was associated with increased risks of singleton pregnancy loss, gestational diabetes, and large for gestational age in women with PCOS.
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0Abortion
1Adult
2Age
3Body mass
4Body mass index
5Complications
6Diabetes
7Diabetes mellitus
8Embryo transfer
9Fasting
10Female
11Fertilization - physiology
12Fertilization in Vitro
13Gestational age
14Glucose
15Glucose Intolerance - blood
16Glucose Intolerance - complications
17Glucose Intolerance - epidemiology
18Glucose tolerance
19Glucose Tolerance Test
20Health risks
21Humans
22Infant, Newborn
23Infertility
24Infertility, Female - blood
25Infertility, Female - complications
26Infertility, Female - epidemiology
27Infertility, Female - therapy
28Insulin
29Laboratory testing
30Male
31Neonates
32Polycystic ovary syndrome
33Polycystic Ovary Syndrome - blood
34Polycystic Ovary Syndrome - complications
35Polycystic Ovary Syndrome - epidemiology
36Pregnancy
37Pregnancy complications
38Pregnancy Complications - blood
39Pregnancy Complications - epidemiology
40Pregnancy Outcome - epidemiology
41Pregnancy Rate
42Risk factors
43Secondary analysis
44Sperm Injections, Intracytoplasmic
45Testosterone
46Young Adult
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8Zhang, Heping
9Chen, Zi-Jiang
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titleEffect of Preconception Impaired Glucose Tolerance on Pregnancy Outcomes in Women With Polycystic Ovary Syndrome
authorWei, Daimin ; Zhang, Bo ; Shi, Yuhua ; Zhang, Lin ; Zhao, Shigang ; Du, Yanzhi ; Xu, Lizhen ; Legro, Richard S ; Zhang, Heping ; Chen, Zi-Jiang
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2Age
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11Fertilization - physiology
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37Pregnancy complications
38Pregnancy Complications - blood
39Pregnancy Complications - epidemiology
40Pregnancy Outcome - epidemiology
41Pregnancy Rate
42Risk factors
43Secondary analysis
44Sperm Injections, Intracytoplasmic
45Testosterone
46Young Adult
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1Zhang, Bo
2Shi, Yuhua
3Zhang, Lin
4Zhao, Shigang
5Du, Yanzhi
6Xu, Lizhen
7Legro, Richard S
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9Chen, Zi-Jiang
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abstractAbstract Context Women with polycystic ovary syndrome (PCOS) commonly have intrinsic insulin resistance and are recommended to undergo an oral glucose tolerance test (OGTT) for diabetes screening. However, the effect of preconception impaired glucose tolerance (IGT) on pregnancy is still unclear. Objective To prospectively assess the effect of preconception IGT on pregnancy outcomes. Design, Setting, Patients, Interventions, and Main Outcome Measures This was a secondary analysis of a multicenter randomized trial in 1508 women with PCOS comparing live birth and obstetric complications between fresh and frozen embryo transfer. At baseline, fasting and 2-hour glucose and insulin levels after 75-g OGTT were measured. Results Women with preconception IGT had higher risks of gestational diabetes in both singleton pregnancy [9.5% vs 3.2%; odds ratio (OR) 3.13; 95% confidence interval (CI) 1.23to 7.69] and twin pregnancy (20.0% vs 3.2%; OR 7.69; 95% CI 2.78 to 20.00) than women with normoglycemia. Preconception IGT was associated with a higher risk of large for gestational age in singleton newborns compared with normoglycemia (34.7% vs 19.8%; OR 2.13; 95% CI 1.19 to 3.85) or isolated impaired fasting glucose (i-IFG) (34.7% vs 15.4%; OR 2.94; 95% CI 1.33 to 6.25). Women with preconception IGT had a higher singleton pregnancy loss rate than women with i-IFG (31.4% vs 17.5%; OR 2.17; 95% CI 1.11 to 4.17). After adjusting for age, body mass index, duration of infertility, total testosterone level, and treatment groups (frozen vs fresh embryo transfer), these associations remained. Conclusions Preconception IGT, independent from BMI, was associated with adverse pregnancy outcome compared with i-IFG and normoglycemia. Preconception IGT independent from obesity was associated with increased risks of singleton pregnancy loss, gestational diabetes, and large for gestational age in women with PCOS.
copWashington, DC
pubEndocrine Society
pmid28938429
doi10.1210/jc.2017-01294