I have several large PDF reports (>500 pages) with a form overlay containing grid lines and background that I converted from postscript using GhostScript's ps2pdf in a batch process. The PDFs that get created look perfect in the Adobe Reader. 

However, when I go to print the PDF from Adobe Reader I get about 4-5 ppm from our Dell laser printer with long, 10+ second pauses between each page. The same report PDF generated from another proprietary process (not GhostScript) yeilds a fast 25+ ppm on the same printer. 

The PDF file sizes on both are nearly the same at around 1.5 MB each, but when I print both versions of the PDF to file (i.e. postscript), the GhostScript generated PDF postscript output is about 5 times larger than that of the other (2.7 mil lines vs 675K) or 48 MB vs 9 MB. Looking at the GhostScript output, I see that the form pattern for the grid lines/shading (referenced by "/PatternType1" tag) is defined many thousands of times throughout the file, where it is only defined once in the other PDF output. I believe this constant re-defining of the background pattern is what is bogging down the printer.