Hyperandrogenism and phenotypes of polycystic ovary syndrome are not associated with differences in obstetric outcomes.

OBJECTIVES: To investigate obstetric outcomes in Danish women with different phenotypes of polycystic ovary syndrome (PCOS) and isolated hyperandrogenism (HA) and describe the risk of adverse obstetric outcomes in women with PCOS and HA compared to controls. DESIGN: Cohort study. SETTING: Odense University Hospital, Denmark. POPULATION: Women with PCOS were identified prospectively starting in 1997. Singleton pregnancies in women with PCOS and HA during 2003-2011 were included (n = 199). A control group was matched to the patient cohort according to date of childbirth (n = 995). METHODS: Data on clinical characteristics and obstetric outcomes were collected in patients with PCOS and HA and controls. In PCOS and HA, total and free testosterone, sex hormone binding globulin, and hemoglobin A1c were measured outside pregnancy. During pregnancy, oral glucose tolerance tests were performed in 39 patients and 123 controls according to Danish national guidelines. PCOS phenotypes were based on the Rotterdam criteria. MAIN OUTCOME MEASURES: Gestational diabetes mellitus, pregnancy-induced hypertension, preeclampsia, delivery by emergency cesarean section, preterm delivery and anthropometric measures in the newborn. RESULTS: The incidence of adverse obstetric outcomes and anthropometric measures among the newborns were comparable between different phenotypes of PCOS and patients with HA. In the oral glucose tolerance test, patients had a higher risk of gestational diabetes mellitus compared with controls; the odds ratio (95% confidence interval) was 3.3 (1.5-6.9) after adjustment for age, parity, and body mass index (p = 0.002). The incidence of other adverse obstetric outcomes was similar in patients and controls. CONCLUSIONS: Obstetric outcomes were comparable in women with different PCOS phenotypes.

Psychological aspects of endometriosis: differences between patients with or without pain on four psychological variables.

OBJECTIVE: Women with endometriosis often have pain symptoms that seemingly do not relate to the stage of disease. It has been suggested that psychological factors may contribute to this disproportion. The purpose of this study was to compare patients with and without pain symptoms to see whether they differed in profile on four psychological parameters. STUDY DESIGN: Sixty-three women with laparoscopically diagnosed endometriosis of whom 20 were symptom free, completed four psychometric tests assessing coping, emotional inhibition, depression, and anxiety. RESULTS: Significant positive correlations were found between coping and depression/anxiety, and between pain severity and subjective psychosocial impairment. There were no significant differences between the two groups on depression or anxiety and no correlations between pain severity and depression/anxiety. CONCLUSION: Coping appears to be of major importance to the psychological consequences of endometriosis. This may have implications for the treatment of endometriosis. The study could not confirm previous findings of pain related to endometriosis being associated with a higher prevalence of depression and anxiety.

[Obese pregnant women have complicated deliveries]. / Overvaegtige kvinder har komplicerede fødselsforløb.

INTRODUCTION: On the background of the increasing prevalence of overweight and obesity, we wanted to describe the deliveries among this group of women. MATERIAL AND METHODS: A prospective study of 798 pregnant women during 1 1/2 year. According to Body-Mass-Index (BMI) all referred women were divided into three groups considering their age and parity. A) 270 pregnant women with BMI 26-30. B) 132 pregnant women with BMI > 30. C) 320 pregnant women with BMI 20-25, the control group. RESULTS: The deliveries were induced at 9% and 11% in group A and group B, making a significant difference to the induction of 5% among the controls (p < 0.05). The most frequent reason for induction was graviditas prolongata. This was the case for 5% in group A and 6% in group B compared to 3% in group C. This was not significant (p = 0.24). The rates of cesarean section were 19% and 24% in group A and B, making a significant difference to the rate of 9% among the controls (p < 0.01). Disproportio foetopelvina and late decelerations were the most frequent reason for cesarean section during delivery. Disproportio foetopelvina discovered during delivery was the case for 5% in group A and 8% in group B compared to 1% in group C. This difference is significant with p < 0.05. DISCUSSION: Our study shows that obese and pregnant women have a high rate of induction and postdatism. They have a higher rate of cesarean section compared to normal weight women and get more frequently cesarean section during delivery because of disproportio foetopelvina. Health service professionals working with pregnant women should be aware of the overweight problems.