Risk of preterm delivery in non-diabetic women with polycystic ovarian syndrome

Objective: To examine the risk and etiology of preterm delivery in women with polycystic ovary syndrome (PCOS). Study Design: Retrospective cohort study comparing preterm delivery rate among non-diabetic PCOS and non-PCOS women with singleton pregnancy. Multivariable logistic regression was used to identify predictors of preterm delivery among PCOS women. Result: Among 908 PCOS women with singleton pregnancy, 12.9% delivered preterm compared with 7.4% among non-PCOS women (P < 0.01). Causes of preterm delivery among PCOS women included preterm labor (41%), cervical insufficiency (11%), hypertensive complications (20%), preterm premature rupture of membranes (15%), fetal-placental concerns (9%) and intrauterine fetal demise (5%). Maternal age, race/ethnicity and nulliparity were significant predictors of preterm delivery in PCOS, whereas body mass index and fertility medications were not. Conclusion: A higher proportion of PCOS women delivered preterm (12.9%) compared with non-PCOS women, with the majority of cases due to spontaneous preterm birth. Future studies should explore etiologies and strategies to improve pregnancy outcomes in PCOS. Journal of Perinatology (2012) 32, 770-776; doi:10.1038/jp.2011.194; published online 19 January 2012