PCOS and Complications That Can Occur During Pregnancy
Women with PCOS (Polycystic Ovarian Syndrome), sometimes called PCOD (Polycystic Ovary Disorder), often suffer from infertility as a result of Polycystic Ovaries and other symptoms. Women who are pregnant with PCOS suffer higher rates of pregnancy complications, such as miscarriage, gestational diabetes, pregnancy-induced hypertension, pre-eclampsia, macrosomia, small babies for gestational age, preterm birth, and stillbirth. This page will introduce these various conditions, and they will be covered in more detail in subsequent pages. The general message we want to convey is that taking good care of your health by eating a nutritious diet, exercising regularly, and taking targeted nutritional supplements can give you and your baby the best chance for a trouble-free pregnancy.
Understanding PCOS and Insulin Resistance
You’re pregnant and excited, but PCOS can create the need for you to take extra steps to assure you have a safe and joyful delivery. Women with PCOS (Polycystic Ovarian Syndrome) who become pregnant can experience more health problems than women in the general population, including gestational diabetes, pregnancy-induced high blood pressure, miscarriage, and premature delivery.1
All of these serious problems are yet more evidence that it is extremely important to address PCOS and make the lifestyle changes necessary to manage it and control an underlying influence called 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.
Insulin Resistance is a condition that reduces the sensitivity of your body’s cells to insulin.13 Insulin is required to allow glucose (blood sugar) into your bloodstream where it’s converted into the energy. When Insulin Resistance occurs these same cells slowly become ‘resistant’ when your insulin spikes or surges too often. These ‘spikes’ are most likely caused by a daily diet rich in refined carbohydrates. PCOS symptoms are the end result.
Understanding the Health Risks of PCOS
If you are pregnant and have PCOS you are at higher risk for:1
- High blood sugar levels that can lead to diabetes
- Pregnancy-induced high blood pressure
- Miscarriage (300-percent greater risk)
- Premature delivery
In addition, researchers have documented health issues such as Preeclampsia (high blood pressure, protein traces in the urine), macrosomia (excessive birth weight with babies bigger than 4,500 grams at birth), and clotting factors, in pregnant women with PCOS.2
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Possible Complications with a PCOS Pregnancy
The Department of Reproductive Medicine and Gynaecology at the University Medical Center Utrecht in The Netherlands said, “…Women with PCOS are at increased risk of pregnancy and neonatal complications. Pre-pregnancy, antenatal and intrapartum care should be aimed at reducing these risks.”10 Some of the pregnancy problems you might encounter with a PCOS pregnancy can include:
Even though you may never have had diabetes, you can experience high blood sugar levels during pregnancy, which is known as gestational diabetes. This complication affects about four percent of 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.
It’s not just the mother who is at risk though when it comes to obesity. PCOS women can have SGA (small-for-gestational-age) newborns according to some experts. One University of Chile study found, “PCOS mothers showed a higher prevalence of gestational diabetes and SGA newborns, which cannot be attributed to the weight gain during pregnancy, and seems to be more related to the BMI at the initiation of pregnancy, and to the PCOS condition of the mother.”11
If you have been diagnosed with PCOS before pregnancy, then you should be screened for gestational diabetes in early pregnancy,9 with referral to a specialized obstetric diabetic service when abnormalities are detected. You should also 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. As for treating diabetes with drugs like Metformin throughout the pregnancy, some experts are uncertain. A study by the American University of Beirut Medical Center said, “Apart from the role of Metformin in improving the metabolic consequences accompanying PCOS, it has been shown to improve pregnancy rates in women with PCOS who are resistant to clomiphene citrate. …Whether metformin should be administered throughout pregnancy still remains controversial.”12
Pregnancy-induced High Blood Pressure
Some studies have demonstrated you are at a higher risk of pregnancy-induced high blood pressure if you have PCOS.4 However, other studies show 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. You should ensure that your physician documents your blood pressure throughout the pregnancy.
Miscarriage and Insulin Resistance
If you have PCOS and are successful at becoming pregnant, then you could be at a higher risk of miscarriage than those women 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.
If you are pregnant and have PCOS, then elevated levels of insulin can interfere with the normal balance between factors promoting blood clotting and those promoting the breakdown of the clots. High insulin levels can 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 can be a miscarriage.6
PCOS is associated with a 30-40 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 might play a role. Insulin dysfunction has been identified as an independent risk factor for EPL. PCOS studies suggest hyperinsulinemia suppresses endometrial expression of glycodelin, a protein whose circulating concentration reflects endometrial function. Glycodelin is secreted by the endometrium and might inhibit the endometrial immune response to the embryo, and likely plays a critical role during implantation and in the maintenance of pregnancy.7
Preeclampsia and Macrosomia
Preeclampsia 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 for You
You can take certain steps to improve your overall health that can 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, balancing your hormonal systems and getting a sufficient, balanced supply of the right vitamins, minerals, and botanicals. The Insulite PCOS System incorporates all of these elements to managing PCOS and Insulin Resistance, which can be helpful in reducing health risks during pregnancy.
Because there is no single solution that can reverse Polycystic Ovarian Syndrome or Insulin Resistance, we believe you need to rely on a multi-faceted approach to improving these conditions. What is required is a complete system, including nutritional supplements (vitamins, minerals, and botanicals that are condition specific), a realistic exercise program, nutritional guidance, a support network that can help you change unhealthy lifestyle choices and address the issues presented by these disorders, and information sources like those found on this website. If you analyze the Insulite PCOS System, you’ll find the five elements of this system will be your best choice for supporting your health, controlling your PCOS, and increasing your chances of conceiving and having a healthy pregnancy.
- “Polycystic Ovary Syndrome (PCOS),” National Institute of Child Health and Human Developmenthttp://www.nichd.nih.gov/health/topics/Polycystic_Ovary_Syndrome.cfm (May 2007)
- 2 “Polycystic ovary syndrome (PCOS) Fact Sheet,” Department of Health and Human Services Office on Women’s Health http://www.womenshealth.gov/publications/our-publications/fact-sheet/polycystic-ovary-syndrome.cfm (March 2010).
- “”Overview of Polycystic Ovary Syndrome (PCOS),” Northwestern University http://www.pcos.northwestern.edu
- “Polycystic Ovary Syndrome,” Wikipedia, the free encyclopedia http://en.wikipedia.org/wiki/Polycystic_ovary_syndrome#Medications (May 2012)
- “Prevalence of hyperandrogenemia in the polycystic ovary syndrome diagnosed by the National Institutes of Health 1990 criteria,” The David Geffen School of Medicine at UCLA, Los Angeles, California, April 2010 http://www.ncbi.nlm.nih.gov/pubmed/19249030 (26 February 2009)
- “Association of the genetic variants of luteinizing hormone, luteinizing hormone receptor and polycystic ovary syndrome,” PubMed, April 2012 http://www.ncbi.nlm.nih.gov/pubmed/22546001
The Insulite PCOS System is not intended to be medical treatment, nor is information on this website intended to be a substitute for the advice or care of a health-care practitioner. The Insulite PCOS System is a combination of nutritional supplementation and lifestyle programs intended to help individuals better manage their health and wellbeing. Consult a health-care practitioner before beginning the Insulite PCOS System. Because of ongoing research, clinical experience, and the rapid accumulation of information relating to the subject matter discussed on this website, the website’s users are advised to carefully review and evaluate the information on this website and continue to expand and broaden their knowledge of new information as it becomes available on this website and elsewhere. The use or application of the information contained on this website is at the sole discretion and risk of the user.
Since June 2008, Insulite Laboratories and Insulite Health has supported more than 2.4 million women through the Insulite PCOS System, through this website, through emails providing information and support, through consultations with our Consulting & Advisory Team, through telephone conference calls, through online webinars, through published articles, and most recently, through social media community building and support efforts. Insulite Laboratories and Insulite Health are singularly dedicated to improving the lives of women with PCOS and conditions resulting from Insulin Resistance.