PCOS Does Not Worsen Outcomes in Women With Gestational Diabetes: Study

A new study published in The Journal of Clinical Endocrinology and Metabolism showed that among women with gestational diabetes (GDM), those with polycystic ovary syndrome (PCOS) had similar rates of adverse maternal and neonatal outcomes compared with those without PCOS. Additionally, PCOS did not influence weight loss outcomes with a low-energy diet.

PCOS, a common hormonal condition affecting women of reproductive age, is known to increase the likelihood of developing GDM. Both conditions are tied to impaired insulin sensitivity and adiposity, raising concerns that women with both diagnoses may face compounded pregnancy risks. However, findings from a secondary analysis of the DiGest suggest that the overlap may not translate into substantially poorer maternal or neonatal outcomes.

The study examined 425 pregnant women with GDM and a BMI of at least 25 kg/m² across 8 UK centres. Of these, 50 women had a diagnosis of PCOS, while 375 did not. All participants were part of the DiGest trial, which compared a reduced-energy diet of 1,200 kcal per day with a standard-energy 2,000 kcal per day diet from 29 weeks of pregnancy until delivery.

This research assessed maternal weight changes, glucose metrics, physical activity, dietary intake, and key infant outcomes, including birthweight and incidence of jaundice. Univariate tests and multivariable regression models were used to determine whether PCOS independently influenced results.

At baseline, women with GDM and PCOS had similar characteristics to those with GDM alone. Measures of glycemia, BMI, and overall pregnancy outcomes did not significantly differ between the two groups. The effectiveness of the reduced-energy dietary intervention appeared consistent regardless of PCOS status. Women with PCOS did not experience diminished benefits from dietary management when compared to their counterparts without the condition.

The infants born to mothers with PCOS had higher rates of neonatal jaundice. Approximately 24.4% of infants in the PCOS group developed jaundice, when compared to 8.9% in the non-PCOS group. Despite this finding, most other maternal and neonatal outcomes were comparable.

The results suggest that, in women with GDM whose BMI and blood glucose levels are similar, PCOS alone does not appear to confer additional broad risks for adverse pregnancy outcomes. Overall, this study note that earlier assumptions which linked PCOS to poorer outcomes may reflect confounding factors like higher BMI or more severe hyperglycemia rather than PCOS itself.

Source:

Kusinski, L. C., Liu, Z., Dib, S., Rogers, R., Morrison, A. E., Jones, D. L., & Meek, C. L. (2026). Association between polycystic ovary syndrome and pregnancy outcomes in GDM: A secondary analysis of the DiGest trial. The Journal of Clinical Endocrinology and Metabolism, dgag026. https://doi.org/10.1210/clinem/dgag026