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https://hdl.handle.net/2440/134934
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Type: | Journal article |
Title: | Clinical management of pregnancy in women with polycystic ovary syndrome: An expert opinion |
Author: | Bahri Khomami, M. Teede, H.J. Joham, A.E. Moran, L.J. Piltonen, T.T. Boyle, J.A. |
Citation: | Clinical Endocrinology, 2022; 97(2):227-236 |
Publisher: | Wiley |
Issue Date: | 2022 |
ISSN: | 0300-0664 1365-2265 |
Statement of Responsibility: | Mahnaz Bahri Khomami, Helena J Teede, Anju E. Joham, Lisa J. Moran, Terhi T. Piltonen, Jacqueline A. Boyle |
Abstract: | Polycystic ovary syndrome (PCOS) is associated with a higher risk for pregnancy and birth complications according to the specific features associated with PCOS. The features include obesity before and during pregnancy, hyperandrogenism, insulin resistance, infertility, cardiometabolic risk factors, and poor mental health. PCOS is not often recognized as a risk factor for poor pregnancy and birth outcomes in pregnancy care guidelines, while its associated features are. Pregnancy‐related risk profile should ideally be assessed for modifiable risk factors (e.g., lifestyle and weight management) at preconception in women with PCOS. Hyperglycaemia should be screened using a 75‐g oral glucose tolerance test at preconception or within the first 20 weeks of pregnancy if it has not been performed at preconception and should be repeated at 24–28 weeks of pregnancy. In the absence of evidence of benefit for strategies specific to women with PCOS, the international evidencebased guidelines for the assessment and management of PCOS recommend screening, optimizing, and monitoring risk profile in women with PCOS (at preconception, during and postpregnancy) consistent with the recommendations for the general population. Recommended factors include blood glucose, weight, blood pressure, smoking, alcohol, diet, exercise, sleep and mental health, emotional, and sexual health among women with PCOS. The guidelines recommend Metformin in addition to lifestyle for assisting with weight management and improving cardiometabolic risk factors, particularly in those with overweight or obesity. Letrozole is considered the first‐line pharmacological treatment for anovulatory infertility in PCOS. Individualized approach should be considered in the management of pregnancy in PCOS. |
Keywords: | antenatal care gestational weight gain guideline lifestyle polycystic ovary syndrome pregnancy screening treatment |
Description: | First published: 05 April 2022 |
Rights: | © 2022 The Authors. Clinical Endocrinology published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
DOI: | 10.1111/cen.14723 |
Grant ID: | http://purl.org/au-research/grants/nhmrc/2009326 |
Published version: | http://dx.doi.org/10.1111/cen.14723 |
Appears in Collections: | Obstetrics and Gynaecology publications |
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hdl_134934.pdf | Published version | 964.79 kB | Adobe PDF | View/Open |
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