**7.4. PCOS and preterm birth**

There was evidence of a significant positive association between PCOS and preterm births (<37weeks) [109]. It complicates 6 to 15% of pregnancies of PCOS women [110]. Although preterm birth may be higher in this group of women, PCOS by itself may not be an independent risk factor. Patients who have received ovulation induction agents are more likely to be at higher risk of preterm births, because these medications, together with the increased chance of multiple pregnancies related to them, will increase the risk of preterm birth or delivery [111]. Preeclampsia itself is a risk factor for preterm deliveries. Also, Obstetric intervention may be responsible for iatrogenic prematurity [110].

#### **7.5. PCOS and Small for Gestational Age (SGA) and Large for Gestational Age (LGA)**

There is still some controversy as to whether women diagnosed as having PCOS were more likely to have been born small for SGA and LGA, and whether theses baby is more prone to develop the symptoms of PCOS later in life. Whereas the probable association of higher maternal body weight, increased weight gain during pregnancy, and increased prevalence of gestational diabetes in women with PCOS would be expected to produce birth weights higher than the mean. Also, the prevalence of SGA offspring seems to be increased in women with PCOS. Insulin resistance resulting in impaired insulin-mediated growth and the fetal pro‐ gramming hypothesis are the possible explanations for this higher prevalence of SGA infants in mothers with PCOS [33].
