The impact of androgens on pregnancy and fetal outcomes in patients with polycystic ovary syndrome

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research Pub Date : 2025-08-31 DOI:10.1111/jog.70056

Ömer Tammo, Esra Söylemez, Yusuf Ziya Kızıldemir, Mehmet İncebıyık, Muhammet Erdal Sak

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Abstract

Introduction

Polycystic ovary syndrome (PCOS) is a complex endocrine disorder affecting approximately 20% of women of reproductive age. The impact of high androgen levels on pregnancy and fetal outcomes is complex and multifaceted, largely due to the heterogeneous nature of PCOS.

Materials and Methods

This prospective cohort study included 65 pregnant women diagnosed with PCOS (using the Rotterdam criteria) and 65 age-matched healthy pregnant controls at Harran University Hospital. Blood samples were collected at 18–19 weeks of gestation to quantify testosterone and sex hormone-binding globulin (SHBG) levels, and the free androgen index (FAI) was calculated. Demographic and clinical data were recorded, and obstetric complications and birth outcomes were analyzed, adjusting for potential confounding factors using multivariate analysis.

Results

Pregnant women with PCOS exhibited lower parity (1.8 ± 1.0 vs. 2.2 ± 1.3, p = 0.033), lower birth weight (2827.0 ± 579.3 g vs. 3059.1 ± 561.2 g, p = 0.022), and lower SHBG levels (67.8 ± 58.8 nmol/L vs. 125.3 ± 36.8 nmol/L, p <0.001). Conversely, they demonstrated higher BMI (31.1 ± 6.1 vs. 27.6 ± 5.1, p = 0.001), total testosterone (32.6 ± 14.1 vs. 26.1 ± 8.1, p = 0.009), and FAI levels (136.9 ± 128.2 vs. 31.2 ± 39.4, p <0.001). The incidence of complications such as intrauterine growth retardation (IUGR) and small for gestational age (SGA) was higher in the PCOS group, while the healthy birth rate was lower. The incidence of preeclampsia was also higher in the PCOS group. In the PCOS group, the FAI demonstrated a negative correlation with gestational week and birth weight (r = −0.376, p = 0.002), indicating that as these values increased, the FAI exhibited a corresponding decrease.

Conclusions

This study demonstrates the adverse effects of hyperandrogenism on pregnancy and fetal development in women with PCOS, highlighting the clinical significance of this condition. Further research is required to elucidate the underlying mechanisms of hyperandrogenism and to identify effective strategies to improve pregnancy outcomes in women with PCOS.

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雄激素对多囊卵巢综合征患者妊娠和胎儿结局的影响

多囊卵巢综合征（PCOS）是一种复杂的内分泌紊乱，影响约20%的育龄妇女。高雄激素水平对妊娠和胎儿结局的影响是复杂和多方面的，主要是由于多囊卵巢综合征的异质性。材料和方法本前瞻性队列研究纳入了哈兰大学医院65名诊断为多囊卵巢综合征的孕妇（使用鹿特丹标准）和65名年龄匹配的健康孕妇对照。于妊娠18-19周采血，定量测定睾酮和性激素结合球蛋白（SHBG）水平，计算游离雄激素指数（FAI）。记录了人口统计学和临床数据，分析了产科并发症和分娩结果，并使用多变量分析调整了潜在的混杂因素。结果PCOS孕妇胎次低（1.8±1.0比2.2±1.3,p = 0.033），出生体重低（2827.0±579.3 g比3059.1±561.2 g, p = 0.022）， SHBG水平低（67.8±58.8 nmol/L比125.3±36.8 nmol/L, p <0.001）。相反，他们表现出更高的BMI(31.1±6.1比27.6±5.1,p = 0.001)，总睾酮（32.6±14.1比26.1±8.1,p = 0.009）和FAI水平（136.9±128.2比31.2±39.4,p <0.001）。PCOS组宫内生长迟缓（IUGR）、小胎龄（SGA）等并发症发生率较高，而优生率较低。多囊卵巢综合征组子痫前期的发生率也较高。在PCOS组中，FAI与孕周和出生体重呈负相关（r = - 0.376, p = 0.002），表明随着这些值的增加，FAI相应降低。结论本研究证实了雄激素分泌过多对PCOS患者妊娠和胎儿发育的不良影响，强调了该疾病的临床意义。需要进一步的研究来阐明雄激素过多的潜在机制，并确定有效的策略来改善多囊卵巢综合征妇女的妊娠结局。

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来源期刊

Journal of Obstetrics and Gynaecology Research 医学-妇产科学

CiteScore

3.10

自引率

0.00%

发文量

376

审稿时长

3-6 weeks

期刊介绍： The Journal of Obstetrics and Gynaecology Research is the official Journal of the Asia and Oceania Federation of Obstetrics and Gynecology and of the Japan Society of Obstetrics and Gynecology, and aims to provide a medium for the publication of articles in the fields of obstetrics and gynecology. The Journal publishes original research articles, case reports, review articles and letters to the editor. The Journal will give publication priority to original research articles over case reports. Accepted papers become the exclusive licence of the Journal. Manuscripts are peer reviewed by at least two referees and/or Associate Editors expert in the field of the submitted paper.