The association between preconception polycystic ovary syndrome and gestational diabetes mellitus among women with and without pre-pregnancy hypertension: a cross-sectional study from Utah's Pregnancy Risk Assessment Monitoring System Survey (2016-2021)

Rachel S Myrer; Emmanuel Adediran; Amy D Ellsworth; Rachel M Ceballos; Ivette Lopez; Joseph B Stanford; Sharon Talboys; Jing Wang; Karen C Schliep

doi:10.26054/d-k952-0keb

Reproductive Endocrinology Thyroid and Metabolic Function

The association between preconception polycystic ovary syndrome and gestational diabetes mellitus among women with and without pre-pregnancy hypertension: a cross-sectional study from Utah's Pregnancy Risk Assessment Monitoring System Survey (2016-2021)

Myrer RS, Adediran E, Ellsworth AD, Ceballos RM, Lopez I, Stanford JB, Talboys S, Wang J, Schliep KC

Published May 2025 The Utah women's health review, 3(1), 40-48

DOI 10.26054/d-k952-0keb PMID 40575759 PMC PMC12201940

RRM Academy Synopsis

Utah mothers with PCOS had gestational diabetes 1.50 times as often

In a Utah survey of 8,314 mothers, mothers with PCOS had gestational diabetes 1.50 times as often as mothers without PCOS. PCOS means polycystic ovary syndrome, now also named PMOS (polyendocrine metabolic ovarian syndrome). The survey ran from 2016 to 2021 and adjusted for social, lifestyle, and health factors.

Key Findings

With every listed factor adjusted, the prevalence ratio for gestational diabetes in mothers with PCOS was 1.50 (95% CI: 1.16–1.95), by birth certificate or survey report.
Using the birth certificate alone, the adjusted ratio was 1.49 (95% CI: 1.11–2.01). Using the survey alone, it was 1.53 (95% CI: 1.16–2.01).
Adjusting only for sociodemographic characteristics, the ratio was 2.02 (95% CI: 1.57–2.59) for the combined birth certificate or survey measure.
In the final model, the ratio was 1.61 (1.22–2.14) for PCOS without hypertension and 1.08 (0.59–1.97) for PCOS with hypertension. The Wald test gave 0.11.
The authors note that only 158 women had both PCOS and pre-pregnancy hypertension, and say this small number may explain why hypertension was not a significant moderator.

Interpretation

A cross-sectional survey of Utah mothers, taken 2–4 months after birth, covered the years 2016 to 2021. Mothers with PCOS had a higher rate of gestational diabetes than mothers without PCOS. The pattern held even after researchers accounted for social, lifestyle, and health differences. The authors note that their numbers were lower than three earlier studies. They say this may reflect Utah's younger, healthier population. The findings support larger studies of PCOS and pregnancy across more diverse groups.

RRM Context

Restorative reproductive medicine treats PCOS as a hormonal and metabolic condition. It affects health before, during, and after pregnancy. In this sample, women with PCOS also reported more obesity, depression, anxiety, and hypertension. The authors call for new programs to prevent gestational diabetes in women with PCOS.

Our editorial summary of this paper, not the article's abstract.

Abstract

Objectives

The objective of this study is to test the association between preconception polycystic ovary syndrome (PCOS) and gestational diabetes mellitus (GDM) using Utah's Pregnancy Risk Assessment Monitoring System (2016-2021). In addition, pre-pregnancy hypertension will be tested as a potential effect moderator.

Methods

This cross-sectional study utilizes data from Phase 8 of the Utah Pregnancy Risk Assessment Monitoring System (PRAMS) survey (2016-2021). The association between PCOS and GDM was tested using Poisson regression to generate adjusted prevalence ratios and 95% confidence intervals.

Results

PCOS was associated with higher prevalence of GDM in all models, regardless of whether the outcome data (GDM) came from the infant's birth certificate, the PRAMS survey, or the combined measure. When adjusting for sociodemographic characteristics, lifestyle factors, reproductive history, and comorbidities, women with PCOS were 1.50 (1.16-1.95) times as likely to have GDM (reported on birth certificate and/or survey) compared to women without PCOS. Pre-pregnancy hypertension was not found to be a statistically significant effect moderator.

Conclusions

The findings from this study were consistent with the majority of research indicating that women with PCOS have increased risk for GDM. This is also the first known study to test pre-pregnancy hypertension as an effect moderator between PCOS and GDM. More research is needed on the role of comorbidities such as chronic hypertension as effect modifiers between PCOS and GDM.

Implications

These findings show that women with PCOS are at high risk for GDM, among a population-based sample of mothers. Interventions to reduce the risk of GDM among women with PCOS need to be developed and evaluated.

Read the guide

PMOS / PCOS: Causes, Diagnosis, and Treatment

Topics

Reproductive Endocrinology › Thyroid and Metabolic Function › Insulin and Metabolism · PMOS / PCOS › Long Term Health › Metabolic Risk

Rachel S Myrer, Emmanuel Adediran, Amy D Ellsworth, Rachel M Ceballos, Ivette Lopez, Joseph B Stanford, Sharon Talboys, Jing Wang, Karen C Schliep

R Myrer, E Adediran, A Ellsworth, R Ceballos, I Lopez, Joe Stanford, Joey Stanford, J Stanford, S Talboys, J Wang, K Schliep

PMID 40575759 40575759 DOI 10.26054/d-k952-0keb 10.26054/d-k952-0keb Myrer et al. 2025, Myrer 2025

The association between preconception polycystic ovary syndrome and gestational diabetes mellitus among women with and without pre-pregnancy hypertension: a cross-sectional study from Utah's Pregnancy Risk Assessment Monitoring System Survey (2016-2021)

Utah mothers with PCOS had gestational diabetes 1.50 times as often

Key Findings

Interpretation

RRM Context

Abstract

Read the guide

Topics

By this author

Related research