Polycystic ovary syndrome (PCOS) is a common hormonal disorder affecting approximately one in eight women globally. While PCOS can be managed with the right care, it is a lifelong condition that can significantly impact a woman’s overall health, including her reproductive health.
Recent research from the Norwegian University of Science and Technology (NTNU) has shed light on the potential effects of PCOS in combination with obesity on pregnancy outcomes. The study has raised important questions about how women with PCOS and obesity fare during pregnancy and the impact this has on their babies’ health.
Understanding PCOS
PCOS is characterized by hormonal imbalances that lead to irregular menstrual cycles, elevated male hormone levels, and small cysts on the ovaries. The hormonal disruptions caused by PCOS often lead to infertility, irregular ovulation, and other metabolic complications. Additionally, women with PCOS are at a higher risk for obesity, type 2 diabetes, and high blood pressure. The effects of PCOS extend beyond reproductive health, influencing various systems within the body.
While some women with PCOS may experience mild symptoms, others face more severe challenges that require medical attention. One of the more concerning aspects of PCOS is its effect on pregnancy. Research has shown that women with PCOS are more likely to experience complications such as gestational diabetes, high blood pressure, and an increased risk of preterm birth.
The Study: Comparing PCOS with a General Population
In a recent study conducted at NTNU, researchers explored the impact of PCOS on the birth outcomes of children born to mothers with the condition. The study compared data from 390 children born to women with PCOS to over 70,000 children born to mothers without PCOS, sourced from the Norwegian Mother, Father, and Child Cohort Study (MoBa).
The results of the study were compelling. The babies born to mothers with PCOS, particularly those who were also obese (with a BMI of 30 or more), were generally smaller in terms of birth weight, length, and head circumference. This finding was especially prominent in the group of mothers with obesity, who experienced a more significant decrease in birth outcomes compared to women of normal weight with PCOS.
Dr. Eszter Vanky, one of the lead researchers at NTNU, emphasized the connection between PCOS and obesity. She noted that while PCOS by itself can result in lower birth weight, it is the combination of PCOS and obesity that creates the most concerning outcomes. Babies born to mothers with both conditions tended to be smaller than those born to mothers without PCOS, even though women with PCOS are also more likely to gain significant weight during pregnancy. This paradox, where mothers gain weight but still deliver smaller babies, has puzzled researchers.
The Role of the Placenta in Pregnancy Complications
One of the most striking findings of the study is the role of the placenta in pregnancies affected by PCOS. The placenta is a critical organ that provides nutrients and oxygen to the developing baby through the umbilical cord. In the case of mothers with PCOS, the placenta was often found to be smaller in size. Despite this, the placenta appeared to work harder to deliver nutrients to the baby, compensating for its reduced size. This overcompensation may be a factor in why babies born to mothers with PCOS are smaller.
However, as Dr. Vanky pointed out, this heightened effort by the placenta sometimes falls short, leading to what is known as placental insufficiency. In severe cases, this can result in restricted growth and, in rare instances, fetal death. The mechanism behind this placental dysfunction is not yet fully understood, though researchers have several hypotheses. One theory is that the hormonal imbalances in PCOS affect the placenta’s ability to function optimally, but more research is needed to establish a clear connection.
Additionally, women with PCOS often have a distinct immune profile during pregnancy, which may influence how the placenta interacts with the fetus. This altered immune response could play a role in the observed birth outcomes.
Why Obesity Complicates PCOS and Pregnancy
Obesity is another key factor that complicates pregnancy in women with PCOS. Women who are overweight or obese before pregnancy are at a higher risk of developing complications such as gestational diabetes and high blood pressure. Moreover, obesity can exacerbate the metabolic challenges that come with PCOS, leading to an even greater risk of poor pregnancy outcomes.
Interestingly, the study revealed that women with PCOS and obesity had a greater likelihood of giving birth to smaller babies compared to women with PCOS alone. This finding is contrary to what is typically observed in pregnancies where women are overweight or obese but do not have PCOS. Generally, overweight women are at higher risk of delivering larger babies, especially if they develop gestational diabetes. However, in the case of PCOS, this pattern is reversed. Researchers believe that the presence of PCOS alters how the body manages pregnancy weight gain and may impact fetal growth in unexpected ways.
Long-Term Effects on Children
The impact of maternal PCOS extends beyond birth. Follow-up studies conducted by NTNU researchers have shown that children born to mothers with PCOS are more likely to develop central obesity, which is characterized by excess fat around the waist. This suggests that these children may be at higher risk for metabolic diseases, such as type 2 diabetes, later in life. It is well-established that low birth weight is linked to an increased risk of developing cardiovascular disease and other chronic health conditions as an adult. Therefore, understanding the long-term effects of maternal PCOS on child health is crucial.
At the age of seven, the children born to mothers with PCOS showed early signs of metabolic imbalance, such as increased waist circumference and a higher BMI. These signs may be early indicators that the children are more likely to develop obesity-related conditions as they grow older. Researchers also found that children born to mothers with PCOS had slightly different immune profiles, which could contribute to their susceptibility to obesity and other chronic conditions.
What This Means for Expecting Mothers
The findings of this study highlight the need for better management of PCOS, especially for women who are also obese. Pregnancy can be a challenging time for women with PCOS, but with the right support, it is possible to reduce risks for both mother and baby. Healthcare providers should offer guidance on maintaining a healthy weight during pregnancy, managing blood sugar levels, and monitoring fetal growth more closely.
The NTNU researchers are eager to explore ways to help mothers with PCOS and obesity optimize their pregnancy outcomes. This includes investigating how early interventions, such as better glucose regulation and prenatal care, can improve the health of both mothers and their children. Educating women about the potential risks associated with PCOS during pregnancy is an important step toward ensuring better health outcomes for future generations.
