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Lack of Fetal Insulin Resistance in Maternal Polycystic Ovary Syndrome

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Abstract

Polycystic ovary syndrome (PCOS) affects 8–10% of women. NIH criteria for diagnosis include chronic anovulation and evidence of clinical or biochemical hyperandrogenism. PCOS is associated with adverse neonatal outcomes. Our hypothesis is that insulin resistance is increased in fetuses born to women with PCOS. This is a prospective cohort of women who delivered at our institution. Subjects with a body mass index < 20 or ≥ 50 kg/m2, multiple gestation, and major fetal malformations were excluded. Maternal blood was collected at admission, and umbilical cord blood was collected after delivery. Serum concentrations of insulin and glucose were measured from each sample. The homeostasis model assessment index of insulin resistance (HOMA-IR) was calculated (plasma glucose (mmol/L) × insulin (μU/mL)/22.5). The HOMA-IR from mothers and fetuses with PCOS was compared with mothers and fetuses without PCOS (controls). Mann-Whitney U test was utilized for statistical analysis. Forty-six women and fetal pairs were included; 28 with PCOS and 18 controls. Maternal insulin (20 [7.7–26.5] vs. 6.6 μU/ml [5.1–7.2]; p = 0.005) and HOMA-IR (3.9 [1.6–4.5] vs. 1.1 [0.9–1.3]; p = 0.01) were increased in the PCOS group. There was no statistical difference in fetal insulin, glucose, or HOMA-IR (p = 0.31) in the umbilical artery (p = 0.10; p = 0.34; p = 0.45, respectively) or the umbilical vein (p = 0.13; p = > 0.99; p = 0.31, respectively). Insulin resistance is present in non-diabetic pregnant women with PCOS, however not in their fetuses. This might explain variations in the occurrence of the adverse neonatal and maternal outcomes reported in PCOS.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, TN, USA

    Ana M Tobiasz, Jose R Duncan, Laura Detti & Giancarlo Mari

  2. Department of Obstetrics and Gynecology, Sanford Obstetrics & Gynecology, University of North Dakota, 414 N Seventh Street, Bismarck, ND, 58501, USA

    Ana M Tobiasz

  3. Department of Obstetrics and Gynecology, University of South Florida, FL, Tampa, USA

    Jose R Duncan

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  1. Ana M Tobiasz
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Correspondence to Ana M Tobiasz.

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The authors declare that they have no conflicts of interest.

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This protocol was approved by the University of Tennessee Institutional Review Board and by the office of research of Regional One Health, Memphis, TN. The study is currently registered at ClinicalTrials.gov (NCT02429349).

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Tobiasz, A.M., Duncan, J.R., Detti, L. et al. Lack of Fetal Insulin Resistance in Maternal Polycystic Ovary Syndrome. Reprod. Sci. 27, 1253–1258 (2020). https://doi.org/10.1007/s43032-019-00125-1

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  • DOI: https://doi.org/10.1007/s43032-019-00125-1

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