PCOS and pregnancy
Pregnancy is an exciting time, especially because so many women with PCOS have been trying to conceive for years. Having PCOS and being pregnant, however, poses additional risks for women with the syndrome, especially for developing gestational diabetes mellitus (GDM), a condition of high glucose levels during pregnancy.
Women with PCOS have an increased risk of developing GDM, regardless if they are overweight or not. Insulin levels significantly increase in the second and third trimesters of pregnancy as a normal part of pregnancy; the majority of women with PCOS already have high insulin levels.
PCOS and the risk of gestational diabetes
You are at high risk for gestational diabetes if you:
Have previously given birth to a large baby (nine pounds or greater)
Have had gestational diabetes with a past pregnancy
Have glycosuria (sugar in your urine) before or during pregnancy
Have a strong family history of diabetes
Are of older maternal age
Experience excessive weight gain during pregnancy
If not well-managed, gestational diabetes can cause significant problems during pregnancy and labor for both mom and baby.
How women with PCOS can prevent gestational diabetes
The good news is that diet and exercise modifications can help to prevent gestational diabetes. If you have PCOS, here are some of the most effective ways to reduce your chances of developing gestational diabetes during your pregnancy.
Screen early in pregnancy
If you have PCOS and become pregnant, glucose testing should be done as soon as possible to screen for gestational diabetes. If the results are normal, testing should be repeated by the standard screening time for all pregnant women, between 24 and 28 weeks gestation. While early testing won’t prevent GDM, interventions to maintain proper blood glucose levels that are started early on, will help to optimize pregnancy outcomes.
Limit sweets and refined carbs
Since high sugar and refined carbs dramatically increase glucose and insulin levels, they are best to be limited during pregnancy. This includes juice, regular soda, white bread, sugary cereals, pastries and baked goods.
Be sure to include fiber in your meals. This can be from fruits, vegetables, beans, lentils, and whole-grain breads. One large study looked at the diets of women before they got pregnant. Every 10 gram daily increase in fiber reduced their risk of GDM by 26%.
Seek nutrition counseling
Because dieting is never recommended during pregnancy, women with gestational diabetes should receive nutritional counseling from a registered dietitian nutritionist (RDN), such as those at the PCOS Nutrition Center. An RDN can tell you which foods to eat and which to avoid, as well as educate you about ideal portions and meal timing. All of this will help optimize glucose levels and support a healthy pregnancy.
Exercise is extremely important for women with PCOS, especially when it comes to preventing gestational diabetes during pregnancy.
Consistent, moderate-intensity physical activity may improve insulin resistance by lowering blood sugar levels, and aid in weight management in pregnancy. In one study, researchers found that women who were physically active before and during their pregnancy reduced their risk of GDM by about 70% or even more. The women got about 4 hours a week of physical activity. Walking and swimming are great, low impact exercises to do during pregnancy.
It has been shown that myo-inositol (MYO) can reduce the risk of GDM in pregnancy in women with PCOS. One study showed the prevalence of GDM in the MYO group was 17.4% compared with 54% in the control group. More studies are needed to show the benefits and risks of taking MYO in pregnancy. MYO could cause low blood sugar and should only be used in pregnancy under the care of a physician.