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How PCOS High-Risk Pregnancy Occurs

Published on 06/15/25

Polycystic ovary syndrome (PCOS) is a common hormonal condition that affects women of reproductive age. For many women living with PCOS, pregnancy can be a complicated yet rewarding journey.

One common concern for women with PCOS is whether their pregnancy will be considered high-risk. In this blog post, we will explore how PCOS high-risk pregnancy occurs, the complications that may arise, and how you can manage your health during this time.

At Rosh Maternal & Fetal Medicine, we are dedicated to offering compassionate care and support for women with PCOS. By understanding the unique challenges posed by this condition, we can help guarantee a safer, healthier pregnancy journey.

What Is PCOS?

Polycystic ovary syndrome (PCOS) is a condition where the ovaries produce an abnormal amount of androgens, which are male hormones. This can disrupt normal ovulation and make it harder for a woman to get pregnant. Women with PCOS may also have cysts on their ovaries and experience irregular periods, weight gain, acne, and thinning hair.

PCOS can affect many aspects of a woman’s health, including her ability to conceive and her pregnancy’s overall progress. While not every woman with PCOS will face complications during pregnancy, the condition does increase the risk of certain pregnancy-related problems.

How PCOS Leads to a High-Risk Pregnancy

A high-risk pregnancy refers to a pregnancy where the mother or baby has a higher-than-usual chance of developing complications. For women with PCOS, a variety of factors contribute to the increased risk. These include hormonal imbalances, difficulty conceiving, and the associated health conditions that often accompany PCOS, such as diabetes or high blood pressure.

The following are the most common ways that PCOS can lead to a high-risk pregnancy:

  • Difficulty Getting Pregnant

Women with PCOS often face challenges with conception due to irregular or absent ovulation. This is one of the main reasons PCOS can be associated with infertility. Although many women with PCOS can eventually get pregnant with the help of fertility treatments, this struggle can delay pregnancy and add an extra layer of stress.

If you are able to conceive with the help of fertility treatments, such as ovulation-inducing medications or IVF, you may face additional monitoring during pregnancy to ensure a healthy outcome.

For instance, women who conceive via fertility treatments may be at a higher risk of multiple pregnancies (twins, triplets, etc.), which can further increase the risks during pregnancy.

  • Gestational Diabetes

Women with PCOS are at an increased risk of developing gestational diabetes, a form of diabetes that occurs during pregnancy. Gestational diabetes can affect how the body processes sugar and lead to high blood sugar levels. This condition can cause complications such as premature birth, high birth weight, and an increased risk of cesarean delivery.

Women with PCOS who are overweight are even more likely to develop gestational diabetes. Managing your blood sugar through proper diet and exercise is key to reducing the risks associated with this condition.

If diagnosed with gestational diabetes, your OB/GYN will closely monitor you for any changes, and managing this condition can help make sure both you and your baby stay healthy throughout your pregnancy.

  • Preeclampsia and High Blood Pressure

Preeclampsia is a potentially life-threatening pregnancy complication characterized by high blood pressure and organ damage, usually affecting the liver and kidneys.

Women with PCOS have a higher risk of developing preeclampsia compared to those without the condition. This condition is more likely to develop during the second or third trimester and can cause severe health problems for both mother and baby if left untreated.

Managing your blood pressure and attending regular prenatal checkups are key to detecting preeclampsia early. If left untreated, preeclampsia can lead to serious complications for both the mother and baby, including premature birth, low birth weight, and organ damage. Your doctor will monitor you for any signs and symptoms of preeclampsia, and early treatment can help reduce the risk of complications.

  • Miscarriage and Preterm Labor

Women with PCOS have a slightly higher risk of miscarriage, particularly during the first trimester. The hormonal imbalances that cause irregular ovulation in women with PCOS may also affect the ability of the embryo to implant successfully in the uterus.

Additionally, women with PCOS may be at a higher risk of preterm labor. Preterm labor occurs when the body begins contractions before 37 weeks of pregnancy, and it can lead to complications for the baby, such as low birth weight, breathing problems, and developmental delays. This risk can be particularly heightened if the pregnancy involves multiples.

  • Obesity and Weight Management Issues

Obesity is a common issue for women with PCOS due to the hormonal imbalances that can make it harder to lose weight. Carrying excess weight during pregnancy increases the risk of complications like gestational diabetes, preeclampsia, and difficulty during labor.

Managing your weight before and during pregnancy through a healthy diet and regular exercise is essential for minimizing risks. If you struggle with weight management due to PCOS, it is important to work with your OB/GYN to create a plan that supports both your health and the health of your baby. It is also important to understand that you do not have to make drastic changes to your diet, but gradual changes, such as choosing whole foods and staying active, will help support a healthy pregnancy.

Managing PCOS During Pregnancy

While PCOS does increase the risk of certain pregnancy complications, there are steps you can take to minimize these risks. Regular prenatal visits and close monitoring are essential for managing a PCOS high-risk pregnancy.

Below are some strategies for maintaining a healthy pregnancy with PCOS:

  • Maintain a Healthy Diet: Eating a balanced diet rich in fruits, vegetables, lean proteins, and whole grains can help you maintain a healthy weight and manage gestational diabetes.
  • Exercise Regularly: Exercise helps to regulate blood sugar, manage weight, and reduce stress. It is important to consult your doctor before beginning any exercise routine, but walking, swimming, and prenatal yoga are often recommended.
  • Monitor Blood Sugar Levels: If you develop gestational diabetes, monitoring your blood sugar levels regularly is key to managing the condition.
  • Stay on Top of Prenatal Appointments: Regular visits to your OB/GYN allow for early detection of complications like preeclampsia or high blood pressure. Your doctor will also monitor your baby’s growth and development during ultrasounds.
  • Consider Fertility Treatments: If you are struggling with infertility due to PCOS, working with a fertility specialist may be necessary. Fertility treatments like ovulation induction or IVF can increase your chances of a successful pregnancy.

A PCOS high-risk pregnancy comes with its challenges, but with the right care and management, you can have a healthy pregnancy. Rosh Maternal & Fetal Medicine is here to support you every step of the way. We understand the unique risks that women with PCOS face, and we are committed to providing personalized care to ensure a successful pregnancy outcome.

Experiencing pregnancy with PCOS or planning to conceive with the condition calls for specialized care. Our expert team is ready to support you through each step, offering guidance, answering questions, and providing the care needed to promote a healthy pregnancy and baby.

Please note that this content is for informational purposes only. Always consult your healthcare provider before making any medical decisions.

If you have any questions or need to schedule your next prenatal visit, we are here to help. Contact us today to schedule a consultation with one of our specialists at Rosh Maternal & Fetal Medicine.