Pregnancy with PCOD: gestational diabetes and blood pressure

You may have read that PCOD raises your chances of problems in pregnancy, and the words may have scared you. Here is the calm version. Women with PCOD have a higher chance of gestational diabetes and high blood pressure. Higher chance is not the same as certain. It is a reason to start good care early, not a reason to give up.

PCOD, PCOS and PMOS (the new official name for PCOS) all sit on one spectrum. Your doctor decides how this applies to you. This article is education, not a diagnosis.

Why PCOD is linked to these risks

Insulin resistance is a key part of PCOD. Cells respond poorly to insulin, so the body makes more of it. Pregnancy puts extra demand on insulin, because pregnancy hormones make the body less sensitive to it. If you already have some insulin resistance, your sugar can rise more easily. That is gestational diabetes.

Women with PCOD are also more prone to high blood pressure, which is part of the pattern we call metabolic syndrome. Lean women can have PCOD and insulin resistance too, so these risks are not only about weight.

What gestational diabetes is

Gestational diabetes is high blood sugar that is first found during pregnancy. Often it has no symptoms, which is why doctors test for it. A glucose test is usual, and your obstetrician tells you when. If you have risk factors such as PCOD, your doctor may test earlier or more than once.

If sugar is raised, it can be managed. Many women manage it with food and activity. Some need medicines for a time, which your doctor decides.

High blood pressure in pregnancy

Blood pressure is checked at antenatal visits. This is why you should not skip them. Tell your doctor straight away if you get a severe headache, blurred vision, sudden swelling of the face or hands, or the baby moves less than usual. Do not wait for the next appointment.

Before you conceive

The best time to prepare is before pregnancy.

• Start folic acid as advised.
• Aim for a healthy weight. If you carry extra weight, even a 5 to 10% loss can bring back regular ovulation and periods.
• Stop smoking and alcohol.
• Ask your doctor for a check of your blood pressure and blood sugar. Fasting sugar, HbA1c and insulin are tests doctors use for this.
• Tell your doctor about every medicine and supplement you take. Some medicines for PCOD may need to change when you become pregnant. Take medicines and supplements, including inositol and vitamin D, only on your doctor's advice.

During pregnancy

Early antenatal care matters. Go for your first visit as soon as you know you are pregnant, and keep the appointments, scans and tests that follow.

Eat well, but do not crash diet. A plate with half vegetables and salad, a quarter protein and a quarter whole grains is a sensible pattern for most people. Your obstetrician or dietitian can fit it to your pregnancy. Stay active if your doctor says it is fine. A 10-minute walk after meals is a gentle habit that many people find easy.

If you have gestational diabetes, your care team will show you how to check sugar and what targets to aim for. Follow that advice rather than anything from the internet.

After the baby

Gestational diabetes usually settles after delivery, but it raises your chances of type 2 diabetes later. PCOD may ease for a while after a baby, but it needs ongoing care. Check your blood sugar, blood pressure and cholesterol every year, and see a doctor if your periods are missing for 3 months or more.

What helps most

If you are reading this while already pregnant, the same ideas apply from today. It is never too late to book the next antenatal visit, ask about a glucose test and mention that you have PCOD.

Plan, check, and go early. That means a pre-pregnancy visit if you can, a healthy plate and movement, folic acid as advised, antenatal care from the start, and honest conversations with your doctor.

If you are trying to conceive with PCOD and have not yet had your sugar and blood pressure checked, that is a good first step. You do not need to carry the worry by yourself, and a doctor decides what is right for you.