Association between Polycystic Ovary Syndrome and the Risk of Developing Gestational Diabetes Mellitus: A Retrospective Cohort Study

Abstract

Introduction: Polycystic ovary syndrome (PCOS) is a common endocrine disorder linked to insulin resistance and metabolic derangement and may predispose women to develop gestational diabetes mellitus (GDM). This research evaluated how PCOS relates to GDM risk, metabolic differences between women with and without PCOS, and the impact on maternal and fetal outcomes.

Objectives: To establish the association between PCOS and risk of developing GDM; to assess differences in metabolic indicators (BMI, DIPSI, fasting glucose); to evaluate maternal and fetal outcomes; and to inform early screening and preventive guidelines for women at high risk for GDM.

Methods: A retrospective cohort study was conducted in a tertiary care facility from July 2025 to September 2025. The study population comprised 100 pregnant women with PCOS and 100 without PCOS. Demographic, anthropometric, metabolic (BMI, DIPSI, fasting glucose), and pregnancy outcome data were collected from medical records. Chi-square and independent t-tests were used for analysis with SPSS version 26.

Results: The incidence of GDM was significantly higher in the PCOS group than in the non-PCOS group (42% vs 18%, p<0.001). Women with PCOS had higher mean BMI (28.4±4.1 vs 24.1±3.5 kg/m²), higher DIPSI values (148±32 vs 128±24 mg/dL), and higher fasting blood glucose (95±12 vs 85±8 mg/dL). Maternal and neonatal complications were significantly elevated: preeclampsia (16% vs 5%), cesarean section (48% vs 30%), macrosomia (14% vs 5%), and NICU admissions (20% vs 8%) (p<0.05 for all).

Conclusions: PCOS is a significant independent risk factor for GDM with associated metabolic derangement and increased risk for adverse maternal and neonatal outcomes. Early and proactive screening along with preventive management of GDM in women with PCOS should be encouraged to improve obstetric and neonatal outcomes.