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). 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. RESULTS: Among 908 PCOS women with singleton pregnancy, 12.9% delivered preterm compared to 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, while body mass index and fertility medications were not. CONCLUSIONS: A higher proportion of PCOS women delivered preterm (12.9%) compared to 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.