PCOS, or polycystic ovarian syndrome, is a hormonal disease that affects several women. PCOS is a disorder in which the ovaries generate more male hormones (androgens) than usual. The menstrual cycle, fertility, and appearance of a woman can all be affected by this. PCOS (polycystic ovarian syndrome) is a condition that affects 6 to 15% of women of childbearing age. PCOS symptoms include:
- menstruation cycles that are irregular
- cysts develops in the ovaries.
- weight gain
- infertility
- acne
- balding head or hair thinning
- facial and body hair
- Insulin resistance
According to recent studies, the global prevalence of PCOS is believed to be between 6% and 26%. Women with PCOS may find it difficult to conceive and are more likely to experience problems during pregnancy. However, many women with PCOS can become pregnant and have a healthy baby if they manage their symptoms.
PCOS and Pregnancy
Women diagnosed with PCOS, may find it more difficult to conceive. Furthermore, if they are able to conceive, they are at risk for additional problems throughout pregnancy, labour, and delivery. Furthermore, babies born to PCOS women are more likely to spend time in the neonatal critical care unit or dying before, during, or shortly after birth. Pregnancy complications, which are often connected with PCOS, might be a factor in these concerns. In addition, diseases associated with PCOS, such as metabolic syndrome and elevated androgens, may enhance the dangers to babies.
Pregnancy complications
Miscarriage
Women with PCOS are three times more likely than women without PCOS to miscarry in the first trimester of pregnancy. Metformin appears to lower the risk of miscarriage in pregnant women with PCOS, according to several studies. Other studies, however, have not shown that metformin decreases the chance of miscarriage, thus further research is needed. According to one study, PCOS was identified in 40% to 80% of women who had recurrent miscarriages. According to research, women with PCOS are 30-50% more likely than 10-15% without the disease, to miscarry. PCOS is related to a higher chance of miscarriage, according to some experts, since many women with the disorder are overweight or obese, and obesity is known to increase the likelihood of miscarriage.
Gestational diabetes
Only pregnant women are susceptible to this kind of diabetes. It's curable, and if it's kept under control, it won't harm the mother or the foetus. The problem usually goes away when the baby is delivered. Babies born to mothers with gestational diabetes are often big, have low blood sugar, and have difficulty breathing. Women who have gestational diabetes are more likely to develop type 2 diabetes later in life, as well as their child. When compared to women without PCOS or symptoms, pregnant women with PCOS had a more than twofold higher risk of gestational diabetes.
Preeclampsia
Preeclampsia, which occurs after the 20th week of pregnancy, causes a rise in blood pressure, and can injure the mother's kidneys, liver, and brain. Preeclampsia can progress to eclampsia if not treated. Eclampsia is a condition that can result in organ damage, seizures, and even death. The most common solution for the problem is to deliver the baby, even if it is premature. Preeclampsia may necessitate a C-section birth, which has significant risks for both the mother and the baby. Although data shows that women with PCOS are more likely to develop preeclampsia, there is little evidence to support this association.
Pregnancy-induced high blood pressure
This disease is caused by an increase in blood pressure during the second half of pregnancy. It can develop to preeclampsia if not managed. This kind of elevated blood pressure might potentially have an impact on the baby's birth. Women with PCOS have a two- to four-fold higher risk of pregnancy-induced hypertension (PIH) and preeclampsia, according to two major meta-analyses.
Preterm birth
If a baby is born before 37 weeks of pregnancy, it is called "preterm." Preterm babies are at risk for a range of health issues, both immediately after delivery and some of these issues might be severe later in life. Preterm birth was shown to be more prevalent in women with PCOS (6.7%) than in women without PCOS (4.8%) in one research. Across a study of 13 559 births in PCOS women, 81 (0.6%) were extremely preterm, 93 (0.7%) were very preterm, and 731 (5.4%) were moderately preterm.
Cesarean or C-section delivery
Because of pregnancy problems linked with PCOS, such as pregnancy-induced high blood pressure, pregnant women with PCOS are more likely to undergo C-sections. Since a C-section is a surgical operation, it takes longer to recover than a vaginal birth and carries risks for both the mother and the child.
Risks for mothers-to-be with PCOS
PCOS women are more likely to be obese and rely on reproductive technologies to conceive. According to one research, 60% of women with PCOS are obese. To conceive, almost 14% required the use of reproductive technologies. Women with PCOS are more likely to develop a variety of medical problems during their lives, including:Insulin resistance
elevated cholesterol levels
heart disease
stroke
sleep apnea
possibly an increased risk of endometrial cancer
Risks for the baby
The following are some of the potential risks associated with PCOS for the baby:
Premature birthLarge for gestational age baby
Miscarriage
lower Apgar score.
According to research, if your baby is a female, she has a 50% risk of having PCOS as well.
PCOS and breastfeeding
Women diagnosed with PCOS, may need to manage symptoms even after giving birth. However, the intensity of the symptoms and their severity might vary. Hormonal changes following pregnancy and breast-feeding can sometimes cause symptoms to alter. Even if using insulin to help regulate blood sugar levels, it's safe to breastfeed despite having PCOS.
Caring for PCOS during pregnancy
Blood sugar
Women will probably need to monitor their blood sugar more frequently during pregnancy than they did previously. Blood sugar should be checked as often as the doctor prescribes. It's best to try it before meals, one or two hours after a meal, before bedtime, and during the night. Consult a doctor to find out what the blood glucose levels should be.
Insulin
Women who were already using an insulin pump before becoming pregnant, should continue to do so. Using an insulin pump for the first time during pregnancy is generally not a good idea. However, if alternative forms of insulin are not controlling the blood sugar levels, doctors may recommend switching to an insulin pump.
Medical nutrition therapy
Nutritional treatment should be sought from a dietitian. This personalised healthy eating plan ensures that women obtain the nutrients they need and gain the right amount of weight while keeping blood sugar under control. The dietician may advise reducing intake of carbohydrates, such as potatoes, bread, etc.
Three small meals and two to four snacks each day are recommended. Dietitians may also advise on how frequently to eat and how many calories to consume every day. The most essential thing is to eat a diet rich in nutrient-dense meals and sufficient protein, while avoiding high-sugar items. The best chance is to stay away from junk food and processed foods. To avoid medical problems and enhance foetal growth and development, proper medical care and medical nutrition treatment are essential.
Exercise
Post-meal physical exercise, such as walking for 10 to 20 minutes, can help regulate blood pressure and insulin resistance. Yoga has also been proven to be particularly beneficial in the improvement of fertility and PCOS. Yoga will not treat PCOS, but it will help you feel more connected to your body, restore hormone balance, and improve blood circulation in the pelvic area.
Vitamins
Once the first trimester is completed, doctors will most likely reduce folic acid dosage. During the duration of pregnancy and until ceasing of breastfeeding, the recommended amount of folic acid is usually 0.4 mg (400 micrograms) to 1 mg per day. It is best to inquire with a doctor about any additional prenatal vitamins required.
The most important thing to remember about PCOS and pregnancy is that complications are a definite possibility. Monitoring PCOS symptoms and taking extra precautions during your pregnancy can help lower the chance of these issues. As a result, it is now more necessary than ever to take precautions to ensure a healthy pregnancy. Adopting a healthy lifestyle might increase the chances of having a healthy pregnancy and baby. Maintaining a healthy weight, stopping smoking, limiting alcohol use, eating a nutritious meals, exercising on a regular basis, and sleeping properly are included.
Sources:
https://www.nichd.nih.gov/health/topics/pcos/more_information/FAQs/pregnancyhttps://www.pregnancybirthbaby.org.au/pcos-and-pregnancy
https://www.pcosaa.org/pcos-pregnancy-and-delivery-complications
https://helloclue.com/articles/cycle-a-z/pcos-and-pregnancy
https://www.parents.com/pregnancy/complications/how-does-polycystic-ovarian-syndrome-affect-a-pregnancy/
https://www.yourfertility.org.au/everyone/health-medical/polycystic-ovary-syndrome-pcos
https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome