Increased Prevalence of Gestational Diabetes Mellitus Among Women With Diagnosed Polycystic Ovary Syndrome
A population-based study
- Joan C. Lo, MD12,
- Seth L. Feigenbaum, MPH, MD34,
- Gabriel J. Escobar, MD15,
- Jingrong Yang, MA1,
- Yvonne M. Crites, MD6 and
- Assiamira Ferrara, MD, PHD17
- 1Division of Research, Kaiser Permanente of Northern California, Oakland, California
- 2Division of Endocrinology, Department of Medicine, University of California at San Francisco, San Francisco, California
- 3Division of Reproductive Endocrinology and Infertility, Kaiser Permanente Medical Center, San Francisco, California
- 4Department of Obstetrics, Gynecology and Reproductive Sciences, University of California at San Francisco, San Francisco, California
- 5Department of Inpatient Pediatrics, Kaiser Permanente Medical Center, Walnut Creek, California
- 6Division of Perinatology, Department of Obstetrics and Gynecology, Kaiser Permanente Medical Center, Santa Clara, California
- 7Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, Washington
- Address correspondence and reprint requests to Joan C. Lo, MD, Division of Research, Kaiser Permanente of Northern California, 2000 Broadway St., 2nd Floor, Oakland, CA 94612-2304. E-mail: joan.c.lo{at}kp.org
- GDM, gestational diabetes mellitus
- KPNC, Kaiser Permanente of Northern California
- PCOS, polycystic ovary syndrome
Gestational diabetes mellitus (GDM), defined as carbohydrate intolerance at onset of pregnancy (or first recognition), affects ∼4–7% of pregnancies overall (1–6). Common risk factors include nonwhite race/ethnicity, older age, obesity, and prior GDM (3–7). Other conditions predisposing to glucose intolerance might also increase the risk of GDM.
Polycystic ovary syndrome (PCOS) is a reproductive condition characterized by chronic anovulation, insulin resistance, and androgen excess (8–10). Affected women have an increased risk of glucose intolerance and type 2 diabetes (11–14). Some, but not all, studies suggest the risk of GDM is higher among PCOS versus non-PCOS women (15–18), and several studies note an increased prevalence of polycystic ovarian morphology and symptoms in women with prior GDM (19–21). This study examines the prevalence and association of PCOS and GDM among a large multiethnic population of pregnant women in northern California.
RESEARCH DESIGN AND METHODS
Kaiser Permanente of Northern California (KPNC) is a large integrated health care delivery system providing comprehensive medical care for >3,000,000 members in northern California. There are 14 delivery hospitals with >30,000 births/year. Comprehensive health plan databases of all hospitalizations, ambulatory visits, and laboratory tests are available and linked by unique patient identifiers (22). This study was approved by the KPNC Institutional Review Board.
As previously described (1), we used hospitalization databases to identify third trimester pregnancies between 1 January 2002 and 31 December 2004 …
