Fetal growth, fetal development, and placental features in women with polycystic ovary syndrome: analysis based on fetal and placental magnetic resonance imaging

Objective: Polycystic ovary syndrome (PCOS), a common endocrine-metabolic dysfunction in reproductiveaged women, may be involved in compromised pregnancy and offspring outcomes. This study aimed to investigate whether maternal PCOS affects fetal growth, fetal development, and placental features. Methods: This retrospective case-control study included 60 pregnant women with PCOS (PCOS group) and 120 healthy pregnant women without PCOS (control group). Fetal magnetic resonance imaging (MRI) was performed followed by an ultrasound examination and indications for imaging, including known or suspected fetal pathology, history of fetal abnormality in previous pregnancy or in a family member, and concern for placenta accreta. Fetal MRI images were analyzed for head circumference (HC), abdomen circumference (AC), lung-to-liver signal intensity ratio (LLSIR, a prenatal marker of fetal lung maturity), lengths of liver and kidney diameters in fetuses, and placental relative signal intensity on T2-weighted single-shot fast spin echo (SSFSE) imaging (rSI SSFSE ), and placental relative apparent diffusion coefficient value (rADC). Data on height and weight of offspring were collected through telephone follow-up. Results: Compared to the control group, the PCOS group showed the following characteristics: (1) smaller biparietal diameter and femur length in fetuses ( P =0.026 and P =0.005, respectively), (2) smaller HC in fetuses (evident after 32 weeks; P =0.044), (3) lower LLSIR and smaller dorsoventral length of liver in fetuses (evident before 32 weeks; P =0.005 and P =0.019, respectively), and (4) smaller placental thickness (evident before 32 weeks; P =0.017). No significant differences in placental rSI SSFSE or rADC were observed between the groups (all P >0.05). No significant differences in height and weight of offspring during childhood existed between the groups (all P >0.05). Conclusions: There exist alterations of fetal growth, fetal development, and placental features from women with PCOS.