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PCOS and the risk of pre-eclampsia

  • Ashwini Joshi
    Affiliations
    Harvard Medical School, 25 Shattuck Street, Boston MA 02115, USA

    Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston MA 02215, USA
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  • Ashley Aluko
    Affiliations
    Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston MA 02215, USA

    Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, 25 Shattuck Street, Boston MA 02115, USA
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  • Aaron K. Styer
    Affiliations
    Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston MA 02215, USA

    Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, 25 Shattuck Street, Boston MA 02115, USA

    Colorado Center for Reproductive Medicine (CCRM Boston), 330 Boylston Street, Suite 300, Chestnut Hill MA 02459, USA
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  • Brett C. Young
    Affiliations
    Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston MA 02215, USA

    Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, 25 Shattuck Street, Boston MA 02115, USA
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  • Katherine M. Johnson
    Affiliations
    Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston MA 02215, USA

    Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, 25 Shattuck Street, Boston MA 02115, USA
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  • Michele R. Hacker
    Affiliations
    Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston MA 02215, USA

    Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, 25 Shattuck Street, Boston MA 02115, USA
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  • Anna M. Modest
    Correspondence
    Corresponding author.
    Affiliations
    Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston MA 02215, USA

    Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, 25 Shattuck Street, Boston MA 02115, USA
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      Highlights

      • Retrospective case–control study of 870 patients at an academic medical centre
      • No significant difference in PCOS history in patients with and without pre-eclampsia
      • Stronger, but not significant, association between PCOS and pre-eclampsia if BMI ≥25 kg/m2

      Abstract

      Research question

      What is the association between polycystic ovary syndrome (PCOS) and pre-eclampsia? Data suggest that patients with PCOS are at increased risk of developing pre-eclampsia; however, several studies have not found an independent association between the two.

      Design

      A retrospective case–control study of singleton deliveries at a tertiary care hospital from 2011 to 2015. Patients with pre-eclampsia (cases) were matched to the next delivery without pre-eclampsia (controls) on gestational age week. Medical history data, a diagnosis or clinical features of PCOS and obstetric data, including pre-eclampsia, were abstracted from the medical record. Groups were compared with the chi-squared test, and conditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (95% CI). OR were adjusted for maternal age at delivery and race/ethnicity.

      Results

      This study included 435 cases and 435 controls. Cases were more likely to be Black compared with controls. Age, comorbidities, features of PCOS and use of IVF were similar between groups. Patients with pre-eclampsia were not more likely to have PCOS (8.3%) than those without pre-eclampsia (6.2%, adjusted OR 1.40, 95% CI 0.81–2.30). Sensitivity analyses for body mass index and parity suggested an increased pre-eclampsia risk for patients with PCOS and these additional factors, however no group showed a statistically significant association between PCOS and pre-eclampsia.

      Conclusions

      In this study, a history of PCOS was not associated with the risk of pre-eclampsia. Further investigation is necessary to determine whether there are subgroups of PCOS patients who are at increased risk of pre-eclampsia.
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      Biography

      Ashwini Joshi MD is a graduate of Harvard Medical School and a first-year resident physician in the Department of Anesthesia, Critical Care, and Pain Medicine at Massachusetts General Hospital. Her clinical and academic interests are in women's health, critical care and medical education.
      Key message
      This retrospective case–control study of 870 patients did not find an association between PCOS and pre-eclampsia. Results from subgroups suggest there is a need for further work, particularly in populations of patients with PCOS who may be at increased risk of pre-eclampsia, such as those with higher BMI.