Table 1.

Neonatal outcomes stratified by maternal polycystic ovary syndrome (PCOS) diagnosis.

Outcome	Non-PCOS	PCOS	p-value	OR	95% CI
	N = 35,340	N = 3626
Cesarean delivery	9537 (27.4)	1373 (39.2)	<0.001	1.54	1.43–1.66
Preterm birtha	2686 (7.6)	559 (15.5)	<0.001	1.74	1.53–1.98
Apgar score at 5 min < 7	648 (1.8)	151 (4.2)	<0.001	1.46	1.10–1.93
BWT < 2500 gb	2206 (6.2)	414 (11.4)	<0.001	0.86	0.70–1.07
SGA	2468 (7.2)	306 (8.7)	0.001	0.98	0.84–1.14
BWT > 4000 g	4473 (13.0)	477 (13.6)	0.287	1.07	0.95–1.20
SCN admissionb	2783 (7.9)	502 (14.1)	<0.001	1.21	1.05–1.40
Stillbirth	216 (0.6)	64 (1.8)	<0.001	1.23	0.80–1.89
Perinatal mortality	260 (0.7)	84 (2.3)	<0.001	1.49	1.02–2.18
ICD diagnoses originating in perinatal period	N = 34,756	N = 3552	p-value	OR	95% CI
Any conditions	5371 (15.5)	912 (25.7)	<0.001	1.39	1.25–1.53
Short GA and/or low BWTc	1974 (5.7)	417 (11.7)	<0.001	1.03	0.83–1.27
Infections in perinatal period	1087 (3.1)	214 (6.0)	<0.001	1.36	1.14–1.63
Respiratory distress	1511 (4.3)	337 (9.5)	<0.001	1.35	1.14–1.59
Other pulmonary problems	997 (2.9)	234 (6.6)	<0.001	1.34	1.12–1.61
Feeding problems	1261 (3.6)	256 (7.2)	<0.001	1.28	1.09–1.52
Transitory carbohydrate metabolism disorders	651 (1.9)	144 (4.1)	<0.001	1.24	0.99–1.56
Hemorrhagic, hematological disorders	2073 (6.0)	382 (10.8)	<0.001	1.26	1.08–1.46
Cardiac conditions	243 (0.7)	45 (1.3)	<0.001	0.77	0.52–1.13

Source: Reproduced with permission from The American College of Obstetricians and Gynecologists from Doherty et al.⁶ Published by Wolters Kluwer Health, Inc.

OR: odds ratio; CI: confidence interval; BWT: birth weight; SGA: small-for-gestational age; GA: gestational age; SCN: special care nursery.

Data shown as n (%) and using the adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) summarizing the effects of maternal PCOS on neonatal outcomes while controlling for other risk factors. p-values shown were generated using univariate chi-square test for the univariate comparisons between the groups. All statistically significant effects of PCOS in the adjusted comparisons are shown in boldface.

Recording of a PCOS diagnosis was identified among all women who were hospitalized with a PCOS diagnosis (International Classification of Diseases, 10th Revision (ICD-10): E28.2 or International Classification of Diseases, 9th Revision (ICD-9): 256.4) using the Hospital Morbidity System hospitalization records between 1980 and 2011. Study participants with a recorded PCOS diagnosis were defined as women who had reached 15 years of age in 1980, or later, and who were hospitalized with PCOS as one of the diagnoses noted on their admission between January 1997 and April 2011.

All outcomes adjusted for IVF, Ethnicity (Caucasian, Indigenous, Asian and Other), multiple pregnancy, maternal age (<20, 20–29, 30–39, 40+), parity (0, 1–4, 5+), time epoch (years <1990, 1990–1999, 2000–2011), smoking during pregnancy (yes, no or unreported), maternal hypertension, pre-existing and gestational diabetes and preeclampsia.

Adjustments for additional risk factors—cesarean delivery: maternal mental health disorders, antepartum hemorrhage; preterm birth: maternal mental health disorders, antepartum hemorrhage; Apgar score at 5 min < 7: maternal mental health disorders, gestational age at delivery, fetus small-for-gestational age, fetus large-for-gestational age; BWT < 2500 g and SGA and BWT > 4000 g: antepartum hemorrhage, gestational age at delivery; SCN admission: maternal mental health disorders, antepartum hemorrhage, gestational age at delivery; stillbirth and perinatal mortality: gestational age at delivery.

^aOn 34,650 and 3488 pregnancies non-PCOS and PCOS neonates, respectively, when gestational age at delivery was recorded.

^bExcluding stillbirths.

^cHigh birth weight (ICD diagnoses P08) recorded in 101 (0.3%) and 29 (0.8%) offspring of women with and without PCOS diagnosis, respectively.