Hello. I performed a review of relevant medical literature and an internet search to help answer your question. Your daughter s PCOS history is not relevant at all to her pregnancy, but her SMA syndrome is another matter. There are very few cases documented of pregnant women with SMA syndrome in the medical literature because it is a rare disease in itself. I found a Facebook blog from a young woman with SMA who had a normal full term pregnancy and healthy baby, but she was hospitalized frequently for nausea and vomiting and complications of her SMA syndrome. So there seems to be no evidence that the SMA syndrome affects the pregnancy itself, but the SMA syndrome may flare up more or be more symptomatic during the pregnancy. I would recommend that your daughter see a high-risk obstetrician, or Maternal-Fetal Medicine specialist for her pregnancy. It would be helpful if this doctor, and the doctor who cares for her SMA syndrome, be in good contact so they can work together for her to have the best outcome possible. A doctor or facility that is affiliated with a university or medical school is the best option as university centers are the most current in treatment of rare disorders in pregnancy. Her SMA syndrome doctor might have a recommendation for someone. In the meantime, I hope your daughter s symptoms are well controlled, and I hope she finds an adequate specialist to care for her with this rare and challenging condition. I hope my advice was helpful and answers your question. Best wishes, Dr. Brown