The Prevalence of Gestational Diabetes Mellitus in Polycystic Ovary Disease—A Systematic Review, Meta-Analysis, and Exploration of Associated Risk Factors
Abstract
:1. Introduction
- Oligo- or anovulation.
- Clinical and/or biochemical signs of hyperandrogenism.
- Polycystic ovaries.
2. Materials and Methods
2.1. Selection Criteria
- Studies reporting pregnant women with pre-pregnancy-confirmed PCOS by Rotterdam criteria.
- Studies using either 100 g or 75 g oral glucose-tolerance test (OGTT) for screening GDM.
- Studies including both PCOS and GDM.
2.2. Quality Assessment and Bias
2.3. Statistical Analysis
3. Results
3.1. Study Characteristics
3.2. Prevalence of PCOS in Women with GDM (Retrospective Studies)
3.3. Other Risk Factors in PCOS Contributing to the Development of GDM
4. Discussion
4.1. Risk of GDM in PCOS
4.1.1. Family History of Diabetes, Ethnicity, and Occurrence of GDM
4.1.2. PCOS and Insulin Resistance
4.1.3. GDM and Obesity
4.1.4. GDM and Gestational Weight Gain
4.1.5. GDM and ART
4.2. Prevalence of PCOS in GDM
4.3. Predictors of GDM in PCOS Patients
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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OGTT (75 g) | |||
---|---|---|---|
Threshold for GDM Diagnosis | Fasting (mmol/L (mg/dL)) | 1 h * (mmol/L (mg/dL)) | 2 h ** (mmol/L (mg/dL)) |
ADA | 5.1 (92.0) | 10.0 (180.0) | 8.5 (152.0) |
IADPSG | 5.1 (≥92.5) | 10.0 (≥180.0) | 8.5 (≥153.0) |
WHO | 5.1–6.9 (92.0–125.0) | ≥10.0 (180.0) | 8.5–11.0 (153.0–199.0) |
Author (Reference) | Sample Size | Incidence of GDM n (%) | Prevalence of PCOS (n) | Serial Number |
---|---|---|---|---|
Altieri et al. [40] | 516 | 3 (20%) | 15 | 1 |
Veltman-Verhulst et al. [41] | 50 | 21 (42%) | 50 | 2 |
Han A R et al. [42] | 336 | 10 (2.9%) | 336 | 3 |
Roos N et al. [43] | 1,195,123 | 125 (3.3%) | 3787 | 4 |
Reyes-Munoz et al. [44] | 104 | 14 (26.9%) | 52 | 5 |
de Wilde et al. [37] | 326 | 41 (21.6%) | 189 | 6 |
Ashrafi et al. [45] | 702 | 104 (44.4%) | 234 | 7 |
de Wilde et al. [46] | 72 | 22 (30.5%) | 72 | 8 |
Sawada et al. [47] | 113 | 12 (24.5%) | 64 | 9 |
Pan et al. [48] | 7629 | 636 (20.46%) | 3109 | 10 |
Xiao et al. [49] | 2389 | 64 (18.1%) | 352 | 11 |
Rees et al. [50] | 27,204 | 253 (4.4%) | 9068 | 12 |
Xia et al. [51] | 94 | 31 (32.9%) | 94 | 13 |
Zheng et al. -1 [52] | 566 | 39 (26.5%) | 242 | 14 A |
Zheng et al. -2 [52] | 18,106 | 135 (22.09%) | 877 | 14 B |
Fougner et al. [53] | 791 | 297 (41.1%) | 722 | 15 |
Li et al. [54] | 196 | 47 (23.98%) | 196 | 16 |
Patnaik et al. [55] | 102 | 9 (17.6%) | 51 | 17 |
Ouyang et al. [56] | 434 | 104 (24%) | 434 | 18 |
Wang et al. [57] | 814 | 79 (54.9%) | 144 | 19 |
Sterling et al. [58] | 394 | 11 (15.5%) | 71 | 20 |
Liu et al. [59] | 7678 | 37 (9.7%) | 381 | 21 |
Qiu et al. [60] | 16,506 | 272 (14.49%) | 1876 | 22 |
Total | 1,280,245 | 2366 (10.55%) | 22,416 |
Serial Number | Reference | GDM (n) | PCOS (n) |
---|---|---|---|
1 | [61] | 125 | 15 |
2 | [62] | 1014 | 174 |
3 | [63] | 34,686 | 520 |
4 | [64] | 171 | 44 |
5 | [65] | 261 | 131 |
6 | [66] | 94 | 15 |
Total | 36,351 | 899 |
Serial Number | Factor (Reference) | Evidence (Reference) |
---|---|---|
1. | High BMI [41,46,52,62,67,68,69,70,71,72] | High BMI increases PCOS [41] High BMI causes GDM, but not PCOS [46,61,62,67,68,69,70,71,72] Normal BMI with PCOS had a higher risk of GDM than obese [52] |
2. | IR [73,74,75,76,77,78,79,80,81,82,83,84] | IR was higher in obese PCOS only [78] IR was higher even with a normal BMI [79] Use of insulin sensitizers in patients with PCOS [80,81,82,83,84] |
3. | Gestational weight gain (GWG) [50,73,85,86,87,88] | GWG is higher in certain ethnicities [73] Overweight women have higher GWG [50,85,86,87] |
4. | Ethnicity and family history [56,73,89,90,91] | GWG is higher in certain ethnicities [73] GDM and PCOS both have a higher prevalence in certain ethnicities [50,82,83,84,85,86,87,88,89] |
5. | Multifetal gestation, ART [92,93,94] | GDM is not higher in PCOS conceived with ART if age- and BMI-matched [90] GDM is higher with ART compared to spontaneous conception and in multifetal gestation following ART [93,94] |
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Dube, R.; Bambani, T.; Saif, S.; Hashmi, N.; Patni, M.A.M.F.; Kedia, N.R. The Prevalence of Gestational Diabetes Mellitus in Polycystic Ovary Disease—A Systematic Review, Meta-Analysis, and Exploration of Associated Risk Factors. Diabetology 2024, 5, 430-446. https://doi.org/10.3390/diabetology5040032
Dube R, Bambani T, Saif S, Hashmi N, Patni MAMF, Kedia NR. The Prevalence of Gestational Diabetes Mellitus in Polycystic Ovary Disease—A Systematic Review, Meta-Analysis, and Exploration of Associated Risk Factors. Diabetology. 2024; 5(4):430-446. https://doi.org/10.3390/diabetology5040032
Chicago/Turabian StyleDube, Rajani, Taniqsha Bambani, Sahina Saif, Noha Hashmi, Mohamed Anas Mohamed Faruk Patni, and Noopur Ramesh Kedia. 2024. "The Prevalence of Gestational Diabetes Mellitus in Polycystic Ovary Disease—A Systematic Review, Meta-Analysis, and Exploration of Associated Risk Factors" Diabetology 5, no. 4: 430-446. https://doi.org/10.3390/diabetology5040032
APA StyleDube, R., Bambani, T., Saif, S., Hashmi, N., Patni, M. A. M. F., & Kedia, N. R. (2024). The Prevalence of Gestational Diabetes Mellitus in Polycystic Ovary Disease—A Systematic Review, Meta-Analysis, and Exploration of Associated Risk Factors. Diabetology, 5(4), 430-446. https://doi.org/10.3390/diabetology5040032