Increased prevalence of diabetes and polycystic ovary syndrome in women with a history of preterm birth: a case-control study.

Objective: To test the hypothesis that endocrine and metabolic factors predispose to preterm birth.

Design: A cross-sectional, case-control study.

Setting: Namsos Hospital district (Namsos, Norway).

Population: Women from the Namsos Hospital district with previous preterm births (n = 114) were compared with matched controls with term births (n = 127).

Methods: A clinical examination including transvaginal ultrasound was performed. Fasting blood samples were collected and an oral glucose tolerance test was performed.

Main Outcome Measures: The prevalence of polycystic ovary syndrome (PCOS) diagnosis (Rotterdam criteria) and serum levels of androgens, glucose and insulin.

Results: Twenty-nine of 114 women (25.4%) met the PCOS criteria among women with preterm birth, compared with 18 of 127 (14.2%) among controls (P = 0.03). Eight (7.1%) women with preterm birth were diagnosed with diabetes compared with none in the control group (P < 0.01). Hirsutism was present in 34 (29.8%) women with preterm birth versus 12 (9.4%) in the control group (P < 0.01).

Conclusions: The prevalences of PCOS, diabetes and hirsutism are increased among women with a history of preterm birth. This indicates that endocrine and/or metabolic factors may be involved in the pathogenesis of preterm birth. Women experiencing preterm delivery may have an increased risk of developing diabetes and PCOS later in life.