If you're planning to have a baby but are living with PCOS, you might be wondering whether there are potential risks during pregnancy. Polycystic Ovary Syndrome is one of the most common hormonal disorders in women of reproductive age. While PCOS presents a range of symptoms, its implications during pregnancy often raise concerns.
In this article, we'll shed light on these concerns, highlighting the potential risks while providing you with appropriate management strategies.
But don’t worry—the risks are quite manageable! By understanding the specific challenges associated with PCOS during pregnancy, you can take preventive measures and adopt a lifestyle that significantly minimizes these risks. On our social media, we offer plenty of advice to help and encourage you to adopt a lifestyle that suits your PCOS. It's also a good thing to consult a healthcare professional who can guide you through every step of your pregnancy journey.
So, no need to panic! It's entirely possible to have a smooth pregnancy with PCOS. 😉
The key risks during pregnancy
To recap, PCOS is characterised by, amongst other things: an overproduction of androgens (male hormones), irregular ovulation, and polycystic ovaries as seen on ultrasound. It is also associated with metabolic imbalances, with insulin resistance (affecting over 70% of women with PCOS) and low-grade inflammation topping the list.
Miscarriages
Women with PCOS have a threefold increased risk of miscarriage. (1) This risk is particularly heightened by the excess of androgen hormones, prolactin, and LH (luteinizing hormone). A progesterone deficiency also plays a role. However, there are solutions to prevent miscarriages.
Gestational diabetes
The primary risk during pregnancy associated with insulin resistance is gestational diabetes.
Gestational diabetes refers to elevated blood sugar levels, diagnosed for the first time during pregnancy. It's a temporary form of diabetes that usually resolves after childbirth.
However, it should be taken seriously as women with gestational diabetes may experience a slight increase in blood pressure. Although this is generally not severe, it can raise the risk of preeclampsia. Additionally, gestational diabetes increases the mother's risk of developing type 2 diabetes later in life.(2)
For the baby, the risk includes higher birth weight, which can potentially complicate delivery. These babies may also face a slightly higher risk of becoming obese or developing diabetes later in life.
Pregnancy-induced hypertension
High blood pressure during pregnancy typically develops after the 20th week. Elevated blood pressure can reduce blood flow to the placenta, limiting the baby's supply of oxygen and nutrients, which may **restrict growth.**It can also increase the risk of complications such as preeclampsia.
Preeclampsia
While not all studies agree, PCOS may increase the risk of preeclampsia. This pregnancy complication results in high blood pressure and damage to various organs (such as the kidneys and liver). If left untreated, it can lead to very serious complications for both mother and baby.
Preeclampsia is a pregnancy-related condition that can endanger the lives of both mother and fetus. Preeclampsia can lead to eclampsia, a severe complication characterized by seizures, similar to epilepsy.
It is marked by high blood pressure, significant swelling, and protein loss in the urine. Preeclampsia occurs in the second half of pregnancy, after 20 weeks, and usually resolves after childbirth and the expulsion of the placenta. (Source)
This condition can affect the placenta, thus reducing the amount of nourishment and oxygen the baby receives, which may limit growth. Depending on the situation, doctors may decide to deliver the baby prematurely if they believe it would be safer outside the womb.
In the UK, 1-5% of pregnancies are affected by preeclampsia, most of which occur during the first pregnancy. (3)
Preterm delivery
It has also been shown that women with PCOS have a higher risk of preterm birth. Preterm birth occurs before the 37th week of pregnancy. (4)
Babies born prematurely may face immediate health issues, such as breathing problems, as well as long-term issues like developmental delays or learning difficulties. (5)
But don't worry! In the UK today, preterm birth is very well managed, and most babies fortunately come through without lasting effects, depending largely on the degree of prematurity.
Postpartum depression
Postpartum depression is a type of depression that develops after childbirth.
Mothers experiencing it may feel intense sadness, anxiety, or despair, which can complicate their ability to care for themselves or their baby.
Prompt care is essential for the well-being of both mother and child.
Why are these Risks Associated with PCOS?
The hormonal and metabolic imbalances associated with PCOS can interfere with how the body manages pregnancy. For example, insulin resistance (common in women with PCOS) plays a crucial role in the development of gestational diabetes. To learn more, you can read our article on Insulin Resistance and PCOS – What’s the Link?
The connection between polycystic ovary syndrome and postpartum depression is an active area of research, and several mechanisms have been proposed to explain the relationship between these two conditions:
- Hormonal imbalances related to PCOS can affect mood and emotional well-being, potentially increasing the risk of mood disorders like postpartum depression.
- Women with PCOS are also more vulnerable to psychological stress. Several stressors contribute to this:
- Stress related to PCOS symptoms (such as acne, weight gain)
- Stress from difficulties conceiving (some women go through challenging fertility treatments)
- And the stress related to the emotional challenges all new mothers face.
Prevention strategies
Fortunately, most women with PCOS successfully conceive and give birth to healthy babies!
Here are some key strategies to help you have a smooth pregnancy:
- First and foremost, maintain a healthy lifestyle. A balanced diet and appropriate physical activity are essential, both before and during pregnancy. Diet can indeed help manage PCOS symptoms and minimize risks during pregnancy. The recommendations are generally the same as outside of pregnancy: favour low glycaemic index foods, avoid refined sugars, and eat sufficient high-quality protein. Don’t hesitate to check out our article on the topic: Nutrition and PCOS: The key rules of a diet adapted to your type of PCOS.
- Take the right supplements: pregnancy demands a lot of vitamins and minerals! Choose your multivitamin carefully to support you throughout your pregnancy, and consider supplementing with omega-3s, which contribute to your baby’s brain development and reduce the risk of postpartum depression. (6) Myo-inositol may also have a beneficial effect on managing gestational diabetes (get advice on that from your doctor). (7)
- Get a preconception consultation with a qualified professional. This allows for an assessment of risk factors, so they can be better managed later. For instance, if insulin resistance is detected before pregnancy, you can receive tailored advice to reduce the risk of developing gestational diabetes.
- Ensure regular monitoring: find a gynaecologist you trust to follow your pregnancy, and attend all medical check-ups. Close monitoring will help track your blood sugar and blood pressure. In some cases, medical interventions may be necessary to support your pregnancy, such as medication to manage insulin resistance or therapies to regulate hormones.
- Seek emotional support: managing PCOS can be emotionally challenging. It’s vital to have a strong support network that can provide genuine emotional support. Whether it's your close circle, a support group, your doctor, or a specialised therapist, it’s crucial to surround yourself with positivity.
Conclusion
Being pregnant with PCOS presents challenges. But rest assured, with the right information and support, it is entirely possible to have a smooth and fulfilling pregnancy!
Proactive care, regular monitoring, and open communication with healthcare professionals are key strategies to ensure a successful pregnancy.
And remember, in the vast majority of cases, everything turns out well!
If you want to know more about pregnancy and PCOS, check out our article: How to get pregnant with PCOS?
Références scientifiques
