PCOS is a disorder of chronically abnormal ovarian function and hyperandrogenism, and associated sub-fertility. Insulin resistance is an integral feature of PCOS, particularly in obese women, and non-pregnant women with PCOS exhibit many of the features of the metabolic syndrome, including disturbed lipid metabolism. Treatments to improve conception rates include lifestyle intervention and insulin-sensitising therapy. When a woman with PCOS becomes pregnant she is at increased risk of adverse pregnancy outcome, but it is difficult to determine whether this is independent of obesity. The impact of PCOS on maternal and fetal lipid profiles during pregnancy is unknown. The aim of this study was to assess maternal third trimester and fetal cord blood levels of cholesterol, triglyceride (TG) and high density lipoprotein (HDL) in a BMI-matched case control study (n=21 per group) of PCOS pregnancy. Fetal samples were available from 10 BMI matched case control pairs. Maternal cholesterol [mean (SD) case vs control 6.46(1.37) vs 6.14(1.47) mmol/l, P=0.48], triglyceride [3.13(1.15) vs 2.80(0.92) mmol/l, P=0.38] and HDL [1.84(0.48) vs 1.73(0.37) mmol/l, P=0.42] did not differ between PCOS and control pregnancies. However, in fetal cord plasma TG was higher [0.75(0.12) vs 0.39(0.04) mmol/l, P=0.017] and HDL lower [0.58(0.13) vs 0.94(0.32) mmol/l, P=0.007] in the offspring of PCOS pregnancy. There was no difference in cord blood cholesterol levels. These data suggest that PCOS women who conceive have normalised lipoprotein metabolism that does not differ from healthy, BMI matched women during pregnancy. On the other hand, offspring of women with PCOS do have altered lipoprotein metabolism suggesting that they are sensitive to metabolic features of the intrauterine environment. PCOS mothers may influence offspring development by mechanisms including insulin sensitivity, genetic inheritance or intrauterine effects upon the embryo and foetus via maternal metabolism and placental transfer of nutrients.
01 - 05 Apr 2006
European Society of Endocrinology