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Gestational lipid profile partially mediates adverse obstetric outcomes associated with polycystic ovary syndrome: a multicentre cohort study in China
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DOI：10.1186/s12944-026-03013-1.png)
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Abstract
En 中文
Polycystic ovary syndrome (PCOS) is associated with dyslipidaemia and adverse obstetric outcomes. Even among nonobese women, triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C) levels differ between those with and without PCOS. This study aimed to elucidate the role of gestational lipid profiles in the association of PCOS with obstetric outcomes. This multicentre retrospective cohort study enrolled 2,515 pregnant women from 2016 to 2021 at 3 hospitals (1 provincial and 2 municipal) to assess the associations between maternal PCOS (exposure), obstetric outcomes (cesarean delivery, gestational complications, foetal ultrasonographic biometric measurements and neonatal unit admission), and lipid profile markers (mediators) using multivariate linear and logistic regression models and mediation analyses. Pregnant women with PCOS were more likely to have a cesarean delivery (OR = 1.28, 95% CI 1.08, 1.52) than those without PCOS were. The levels of maternal lipid profile markers were associated with cesarean delivery [triglyceride (log TG): OR = 1.62, 95% CI 1.29, 2.03; high-density lipoprotein-cholesterol (HDL-C): OR = 0.67, 95% CI 0.53, 0.85]. These associations were independent of maternal age, educational attainment, the rate of total gestational weight gain (GWG), gravidity, parity, and neonatal sex. In terms of the association between maternal PCOS and cesarean delivery, the mediation effect of TG was 0.010 (95% CI 0.005, 0.016), and that of HDL-C was 0.007 (95% CI 0.002, 0.013). With respect to the secondary outcomes, both TG and HDL-C partially mediated the link between maternal PCOS and pregnancy hypertensive disorders and biparietal diameter in late pregnancy, whereas only TG partially mediated the effect of maternal PCOS on gestational diabetes mellitus and preterm delivery. HDL-C partially mediated the effect of maternal PCOS on admission to neonatal units. Gestational lipid profile markers partially mediated the link between maternal PCOS and adverse obstetric outcomes, including cesarean delivery, gestational complications, foetal ultrasonographic biometric measurements and neonatal unit admission, across different conception modes, independent of maternal age, educational attainment, the rate of total GWG, gravidity, parity and neonatal sex.
Keywords:
Polycystic ovary syndrome
Gestational lipid profile
Adverse obstetric outcomes
Cesarean delivery
Mediating effect
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