Risk of gestational diabetes in women with PCOS based on body mass index: The Japan Environment and Children's Study

Chihiro Okoshi; Hyo Kyozuka; Toma Fukuda; Shun Yasuda; Tsuyoshi Murata; Hirotaka Isogami; Akiko Sato; Yuka Ogata; Mitsuaki Hosoya; Seiji Yasumura; Koichi Hashimoto; Hidekazu Nishigori; Michihiro Kamijima; Shin Yamazaki; Yukihiro Ohya; Reiko Kishi; Nobuo Yaegashi; Chisato Mori; Shuichi Ito; Zentaro Yamagata; Hidekuni Inadera; Takeo Nakayama; Tomotaka Sobue; Masayuki Shima; Seiji Kageyama; Narufumi Suganuma; Shouichi Ohga; Takahiko Katoh; Keiya Fujimori; Toshifumi Takahashi

doi:10.1210/clinem/dgae293

Risk of gestational diabetes in women with PCOS based on body mass index: The Japan Environment and Children's Study

J Clin Endocrinol Metab. 2024 May 4:dgae293. doi: 10.1210/clinem/dgae293. Online ahead of print.

Authors

Chihiro Okoshi^{1

2}, Hyo Kyozuka^{1

2}, Toma Fukuda^{1

2}, Shun Yasuda^{1

2}, Tsuyoshi Murata², Hirotaka Isogami^{1

2}, Akiko Sato², Yuka Ogata², Mitsuaki Hosoya^{2

3}, Seiji Yasumura^{2

4}, Koichi Hashimoto^{2

3}, Hidekazu Nishigori^{2

5}, Michihiro Kamijima⁶, Shin Yamazaki⁷, Yukihiro Ohya⁸, Reiko Kishi⁹, Nobuo Yaegashi¹⁰, Chisato Mori¹¹, Shuichi Ito¹², Zentaro Yamagata¹³, Hidekuni Inadera¹⁴, Takeo Nakayama¹⁵, Tomotaka Sobue¹⁶, Masayuki Shima¹⁷, Seiji Kageyama¹⁸, Narufumi Suganuma¹⁹, Shouichi Ohga²⁰, Takahiko Katoh²¹, Keiya Fujimori^{1

2}, Toshifumi Takahashi^{2

5}

Affiliations

¹ Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan.
² Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan.
³ Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan.
⁴ Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan.
⁵ Fukushima Medical Center for Children and Women, Fukushima Medical University, Fukushima, Japan.
⁶ Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan.
⁷ National Institute for Environmental Studies, Tsukuba 305-8506, Japan.
⁸ National Center for Child Health and Development, Tokyo 157-0074, Japan.
⁹ Hokkaido University, Sapporo 060-0812, Japan.
¹⁰ Tohoku University, Sendai 980-8574, Japan.
¹¹ Chiba University, Chiba 263-8522, Japan.
¹² Yokohama City University, Yokohama 236-0004, Japan.
¹³ University of Yamanashi, Chuo 409-3898, Japan.
¹⁴ University of Toyama, Toyama 930-0194, Japan.
¹⁵ Kyoto University, Kyoto 606-8501, Japan.
¹⁶ Osaka University, Suita 565-0871, Japan.
¹⁷ Hyogo Medical University, Nishinomiya 663-8501, Japan.
¹⁸ Tottori University, Yonago 683-8503, Japan.
¹⁹ Kochi University, Nan koku 783-8505, Japan.
²⁰ Kyushu University, Fukuoka 819-0395, Japan.
²¹ Kumamoto University, Kumamoto 860-8556, Japan.

PMID: 38703083
DOI: 10.1210/clinem/dgae293

Abstract

Context: Women with polycystic ovary syndrome (PCOS), which is the most common endocrine disorder in women of reproductive age, have a potentially increased risk of gestational diabetes mellitus (GDM).

Objective: To examine the impact of PCOS on GDM based on maternal body mass index (BMI) using data from a large birth cohort study in Japan.

Design: Prospective observational study using data from the Japan Environment and Children's Study (JECS).

Participants: Singleton pregnancies in the JECS during 2011-2014 were included. Mothers with HbA1c levels of ≥6.5% in the first trimester and history of DM or steroid use during pregnancy were excluded.

Main outcome measures: Participants were categorized according to their pre-pregnancy BMIs: G1 (<18.5 kg/m2), G2 (18.5-19.99 kg/m2), G3 (20.0-22.99 kg/m2), G4 (23.0-24.99 kg/m2), and G5 (≥25.0 kg/m2). The impact of PCOS on early (Ed) and late-onset (Ld) GDM for each group was estimated using a multiple logistic regression model.

Results: We included 92774 participants, comprising 2012 PCOS(+) cases. GDM occurrence was higher in women with PCOS (p<0.001). PCOS had no effect on GDM in G1, G2, and G3. In G4, PCOS increased the risk of Ed GDM (adjusted odds ratio [aOR]: 3.27, 95% confidence interval [CI]: 1.29-8.29). In G5, PCOS increased the risk of both Ed (aOR: 2.48, 95% CI: 1.53-4.02) and Ld GDM (aOR: 1.94, 95% CI: 1.23-3.07).

Conclusions: The impact of PCOS on GDM occurrence depended on the pre-pregnancy BMIs, which may facilitate personalized preconception counseling among women with PCOS.

Keywords: Birth cohort study; Gestational diabetes mellitus; Polycystic ovary syndrome; preconception care.

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