Objective:

To systematically evaluate the prevalence of gestational diabetes mellitus (GDM) and its associated factors in women with polycystic ovary syndrome (PCOS).

Approach:

• Literature Search: A comprehensive search was conducted across multiple databases including PubMed, Embase, and Cochrane Library from inception to December 31, 2025, focusing on studies reporting GDM prevalence or associated factors in PCOS.
• Data Analysis: A random-effects model was used to pool prevalence estimates and odds ratios, with Egger’s test assessing publication bias and subgroup analysis exploring heterogeneity.

Key Findings:

• The pooled GDM prevalence in PCOS patients was 24% (95% CI: 20%-28%; prediction interval: 10%-46%), with substantial heterogeneity (I² = 89.9%).
• The prevalence estimate based on cohort studies was 21.7% (95% CI: 17.7%-25.8%).
• GDM prevalence was 26.0% for one-step diagnostic criteria and 18.7% for two-step criteria.
• Associated factors included pre-pregnancy BMI (OR = 1.39), gestational weight gain (OR = 1.58), HOMA-IR (OR = 3.41), and family history of diabetes (OR = 2.88).

Interpretation:

The findings indicate that women with PCOS have a significant prevalence of GDM, influenced by various metabolic and familial factors.

Limitations:

• Substantial heterogeneity in prevalence estimates across studies.
• Variability in diagnostic criteria for GDM and PCOS among included studies.

Conclusion:

PCOS patients are at high risk for GDM.

Sources:

• Systematic Review Registration