Women with polycystic ovary syndrome (PCOS) have 26% higher nulliparity rates and give birth at more advanced ages despite similar family aspirations and higher rates of fertility treatment.

 

Later PCOS diagnosis is associated with double the rate of advanced maternal age at childbirth.

 

A prospective cohort study followed 14,247 Australian women from 1996 (aged 18-23 years) to 2021 (age, 43-48 years), comparing 981 women with self-reported PCOS against 13,266 without PCOS.

 

Participants completed surveys approximately every three years, with data collection including childbirth events, fertility issues, and treatment history from 20 weeks of gestational age, including stillbirths.

 

Analysis focused on comparing parity, maternal age at deliveries, and factors associated with advanced maternal age between groups, with adjustments made for education level, area of residence, marital status, body mass index group, hypertension, and type 2 diabetes.

 

Compared with women without PCOS, those with PCOS had fewer births (1.9 ± 1.2 vs 1.7 ± 1.3; P < .001) and higher nulliparity rates (18% vs 23%; P = .003).

 

PCOS was associated with increased odds of advanced maternal age at first childbirth (adjusted odds ratio [aOR], 1.34; 95% CI, 1.04-1.75) and higher rates of gestational diabetes (aOR, 3.90; 95% CI, 2.99-5.10).

 

Late PCOS diagnosis was linked to increased odds of advanced maternal age at first childbirth (aOR, 1.98; 95% CI, 1.22-3.22), emphasising the importance of early diagnosis.

 

Compared with women without PCOS, those with PCOS were older at first childbirth (28.8 ± 5.5 vs 29.5 ± 5.5 years) and second childbirth (31.1 ± 5.0 vs 32.1 ± 5.2 years) (P < .001 for both).

 

This study was led by Maria Forslund, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg in Gothenburg, Sweden. It was published online in American Journal of Obstetrics & Gynecology.