(678) Impact of body mass index and gestational weight-gain on neonatal outcomes in polycystic ovarian syndrome

Previous studies have shown that women with PCOS are more susceptible to overweight/obesity and experience higher gestational weight gain (GWG), however, none of the studies examined the interaction effect of BMI and GWG on adverse outcomes. In this study, we will examine association of BMI and GWG with neonatal outcomes in patients with PCOS.

Study Design:

This is a retrospective cohort study using California’s linked vital statistics-hospital discharge data (2008-2019). We included patients with singleton births and gestational age of 37-42 weeks. Patients with PCOS were determined using ICD-9 and ICD-10 codes. GWG was used to group the subjects into below, within or above IOM guidelines. Multivariable logistic regression analyses were used to examine interaction between BMI and GWG; adjusted predicted probabilities were calculated and reported as cases per 1,000 births.

Results: A total of 14,201 patients with PCOS were included, of whom 4,201 (29.6%) were normal weight, 3,676 (25.9%) were overweight and 6,324 (44.5%) were obese. In obese patients with GWG above guidelines, probability of macrosomia (204, 95% CI: 190, 218) vs 74, 95% CI: 62, 87) cases per 1000 births), large for gestational weight gain (215 (201, 228)) vs 68 (56, 80)), and shoulder dystocia (24 (18, 29) vs. 13 (7, 18)) were higher as compared to normal weight patients with GWG within guidelines (Table). Although obesity as well as GWG above guidelines were risk factors independently; however, when combined together, the risk of adverse outcomes was much higher.

Conclusion:

Our study shows that excessive weight gain is associated with adverse neonatal outcomes. These results might be helpful for providers to provide counselling during pregnancy in PCOS patients.