Vol 95, No 5 (2024)
Research paper
Published online: 2023-10-20

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Preeclampsia in pregnant women with polycystic ovary syndrome: risk factor analysis based on a retrospective cohort study

Ruoan Jiang1, Yingsha Yao1, Ting Wang1, Baohua Li1, Peiyue Jiang1, Fangfang Wang1, Fan Qu2
Pubmed: 37861221
Ginekol Pol 2024;95(5):365-372.


Objectives: To compare the clinical characteristics of pregnant women with polycystic ovary syndrome (PCOS) and perinatal outcomes with or without preeclampsia (PE) and to factors that are potentially associated with the onset of PE. Material and methods: This was a retrospective study of pregnant women diagnosed with PCOS from January 2017 to December 2021. Eligible patients were divided into two groups based on the presence or absence of preeclampsia: a PE group and a non-PE group. Demographics, clinical characteristics, maternal and perinatal outcomes, and potential factors linked to disease recurrence were analyzed. Results: In total, 616 patients were enrolled and respectively classified into the PE group (n = 51) and the non-PE group (n = 565). The incidence of PE in pregnant women with PCOS was 8.28%; this was significantly higher than that in non-PCOS pregnant women (3.22%, p < 0.001). Logistic regression analysis of the predictive factors for PE in women with PCOS revealed that the combination of maternal hyperandrogenism, a pre-pregnancy BMI ≥ 24 kg/m2, and a family history of cardiovascular disease (CVD) and assisted reproductive techniques (ART) exhibited the steepest receiver-operating characteristic (ROC) curve value at 0.797 [95% confidence interval (CI): 0.733–0.862]. Conclusions: Patients with PCOS have a higher incidence of PE. We identified a series of significant and independent factors associated with PE in PCOS: maternal hyperandrogenism, a pre-pregnancy BMI ≥ 24 kg/m2, and a family history of CVD and ART.

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  1. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004; 81(1): 19–25.
  2. Meier RK. Polycystic Ovary Syndrome. Nurs Clin North Am. 2018; 53(3): 407–420.
  3. Carmina E, Azziz R. Diagnosis, phenotype, and prevalence of polycystic ovary syndrome. Fertil Steril. 2006; 86 Suppl 1: S7–S8.
  4. Palomba S, de Wilde MA, Falbo A, et al. Pregnancy complications in women with polycystic ovary syndrome. Hum Reprod Update. 2015; 21(5): 575–592.
  5. Mills G, Badeghiesh A, Suarthana E, et al. Polycystic ovary syndrome as an independent risk factor for gestational diabetes and hypertensive disorders of pregnancy: a population-based study on 9.1 million pregnancies. Hum Reprod. 2020; 35(7): 1666–1674.
  6. Kjerulff LE, Sanchez-Ramos L, Duffy D. Pregnancy outcomes in women with polycystic ovary syndrome: a metaanalysis. Am J Obstet Gynecol. 2011; 204(6): 558.e1–558.e6.
  7. Francisco C, Wright D, Benkő Z, et al. Competing-risks model in screening for pre-eclampsia in twin pregnancy by maternal characteristics and medical history. Ultrasound Obstet Gynecol. 2017; 50(4): 501–506.
  8. Foroozanfard F, Asemi Z, Bazarganipour F, et al. Comparing pregnancy, childbirth, and neonatal outcomes in women with different phenotypes of polycystic ovary syndrome and healthy women: a prospective cohort study. Gynecol Endocrinol. 2020; 36(1): 61–65.
  9. Valdimarsdottir R, Wikström AK, Kallak TK, et al. Pregnancy outcome in women with polycystic ovary syndrome in relation to second-trimester testosterone levels. Reprod Biomed Online. 2021; 42(1): 217–225.
  10. Christ JP, Gunning MN, Meun C, et al. Pre-conception characteristics predict obstetrical and neonatal outcomes in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2019; 104(3): 809–818.
  11. Xia H, Zhang R, Sun X, et al. Risk factors for preeclampsia in infertile Chinese women with polycystic ovary syndrome: A prospective cohort study. J Clin Hypertens (Greenwich). 2017; 19(5): 504–509.
  12. ACOG Practice Bulletin No. 202: Gestational Hypertension and Preeclampsia. Obstet Gynecol. 2019; 133(1): 1.
  13. Mack LR, Tomich PG. Gestational diabetes: diagnosis, classification, and clinical care. Obstet Gynecol Clin North Am. 2017; 44(2): 207–217.
  14. Appanna G, Kallis Y. An update on the management of cholestatic liver diseases. Clin Med (Lond). 2020; 20(5): 513–516.
  15. O'Gorman N, Wright D, Syngelaki A, et al. Competing risks model in screening for preeclampsia by maternal factors and biomarkers at 11-13 weeks gestation. Am J Obstet Gynecol. 2016; 214(1): 103.e1–103.e12.
  16. Committee Opinion Summary No. 638: First-Trimester Risk Assessment for Early-Onset Preeclampsia. Obstet Gynecol. 2015; 126(3): e25–e27.
  17. Poon LCY, Kametas NA, Valencia C, et al. Hypertensive disorders in pregnancy: screening by systolic diastolic and mean arterial pressure at 11-13 weeks. Hypertens Pregnancy. 2011; 30(1): 93–107.
  18. Sotiriadis A, Hernandez-Andrade E, da Silva Costa F, et al. ISUOG CSC Pre-eclampsia Task Force. ISUOG Practice Guidelines: role of ultrasound in screening for and follow-up of pre-eclampsia. Ultrasound Obstet Gynecol. 2019; 53(1): 7–22.
  19. Joham AE, Palomba S, Hart R. Polycystic ovary syndrome, obesity, and pregnancy. Semin Reprod Med. 2016; 34(2): 93–101.
  20. Joham AE, Boyle JA, Zoungas S, et al. Hypertension in Reproductive-Aged Women With Polycystic Ovary Syndrome and Association With Obesity. Am J Hypertens. 2015; 28(7): 847–851.
  21. Chen MJ, Yang WS, Yang JH, et al. Relationship between androgen levels and blood pressure in young women with polycystic ovary syndrome. Hypertension. 2007; 49(6): 1442–1447.
  22. Quan A, Chakravarty S, Chen JK, et al. Androgens augment proximal tubule transport. Am J Physiol Renal Physiol. 2004; 287(3): F452–F459.
  23. Koster MPH, de Wilde MA, Veltman-Verhulst SM, et al. Placental characteristics in women with polycystic ovary syndrome. Hum Reprod. 2015; 30(12): 2829–2837.
  24. Palomba S, Russo T, Falbo A, et al. Macroscopic and microscopic findings of the placenta in women with polycystic ovary syndrome. Hum Reprod. 2013; 28(10): 2838–2847.
  25. Naver KV, Grinsted J, Larsen SO, et al. Increased risk of preterm delivery and pre-eclampsia in women with polycystic ovary syndrome and hyperandrogenaemia. BJOG. 2014; 121(5): 575–581.
  26. Chen JQ, Wang D, Liu B, et al. Department of Disease Control Ministry of Health, PR China. The guidelines for prevention and control of overweight and obesity in Chinese adults. Biomed Environ Sci. 2004; 17 Suppl(5): 1–36.
  27. Sirmans SM, Pate KA. Epidemiology, diagnosis, and management of polycystic ovary syndrome. Clin Epidemiol. 2013; 6: 1–13.
  28. Ganie MA, Marwaha RK, Dhingra A, et al. Observation of phenotypic variation among Indian women with polycystic ovary syndrome (PCOS) from Delhi and Srinagar. Gynecol Endocrinol. 2016; 32(7): 566–570.
  29. Lønnebotn M, Natvig GK, Benediktsdóttir B, et al. Polycystic ovary syndrome, body mass index and hypertensive disorders in pregnancy. Pregnancy Hypertens. 2018; 11: 32–37.
  30. Bahri Khomami M, Joham AE, Boyle JA, et al. Increased maternal pregnancy complications in polycystic ovary syndrome appear to be independent of obesity-A systematic review, meta-analysis, and meta-regression. Obes Rev. 2019; 20(5): 659–674.
  31. de Mouzon J, Goossens V, Bhattacharya S, et al. Assisted reproductive technology in Europe, 2007: results generated from European registers by ESHRE. Human Reproduction. 2012; 27(4): 954–966.
  32. Schieve LA, Cohen B, Nannini A, et al. Massachusetts Consortium for Assisted Reproductive Technology Epidemiologic Research (MCARTER). A population-based study of maternal and perinatal outcomes associated with assisted reproductive technology in Massachusetts. Matern Child Health J. 2007; 11(6): 517–525.
  33. Pandey S, Shetty A, Hamilton M, et al. Obstetric and perinatal outcomes in singleton pregnancies resulting from IVF/ICSI: a systematic review and meta-analysis. Hum Reprod Update. 2012; 18(5): 485–503.
  34. Carbillon L, Gronier H, Cedrin-Durnerin I, et al. The impact of ovulation induction and ovarian stimulation on the risk of pregnancy-induced hypertension and on neonatal outcomes: A case/control study. Eur J Obstet Gynecol Reprod Biol. 2017; 217: 137–143.
  35. Liu Q, Wang J, Xu Q, et al. A retrospective cohort study of obstetric complications and birth outcomes in women with polycystic ovarian syndrome. J Obstet Gynaecol. 2022; 42(4): 574–579.