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Inflammation from PCOS could cause pregnancy complications
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Women with polycystic ovary syndrome are at greater risk for chronic low-grade inflammation during pregnancy and potentially for developing adverse-related obstetric or neonatal complications and outcomes, according to research published in The Journal of Clinical Endocrinology & Metabolism.
“Women who have PCOS often exhibit low-level inflammation. ... Our research found this state of inflammation worsens during pregnancy,” Stefano Palomba, MD, of Arcispedale Santa Maria Nuova Hospital in Reggio Emilia, Italy, said in a press release. “Other studies have identified a connection between inflammation biomarkers and pregnancy complications such as preeclampsia and gestational diabetes. ... The abnormal inflammation seen in women with PCOS may be a factor in the development of these conditions.”
Stefano Palomba, MD
A prospective controlled clinical study at the academic department of obstetrics and gynecology of the Pugliese-Ciaccio Hospital in Catanzaro, Italy, looked at biological markers of inflammation in 150 pregnant women with PCOS and 150 pregnant women matched for age and BMI. All participants were white; nearly 78% of patients with PCOS had hyperandrogenism.
Palomba and colleagues performed serial clinical, biochemical and ultrasonographic assessments on participants before and throughout pregnancy. The researchers quantified serum levels of white blood cell count (WBC), C-reactive protein (CRP) and ferritin.
In pregnant women with PCOS, researchers observed higher WBC, CRP and ferritin levels at entry into the study and at all gestational ages vs. the control group. Starting from week 12 of gestation, changes in serum WBC and ferritin levels were both significantly higher in women with PCOS vs. those without, whereas a significant difference between the groups’ CRP levels started at week 20. Through multivariable Cox proportional hazard analysis, the researchers discovered significant associations in the PCOS group with the risk of adverse obstetric/neonatal outcomes for WBC (HR=1.52; 95% CI, 1.31-1.64), CRP (HR=1.19, 95% CI, 1.06-1.34) and ferritin levels (HR=1.12, 95% CI, 1.03-1.26).
“The current study confirmed higher markers of chronic low-grade inflammation in PCOS patients and first demonstrated the persistence of high levels of these markers in pregnancy,” the researchers wrote.
“Our data also confirmed an increased risk for obstetric/neonatal complications, with particular regard for pregnancy-induced hypertension, preeclampsia, gestational diabetes, antepartum hemorrhagia and large and/or small for gestational age, and demonstrated a significant association with the risk of adverse obstetric/neonatal outcomes for the low-grade chronic inflammation markers, such as WBC, CRP, and ferritin levels in pregnant women with PCOS.”
Disclosure: The researchers report no relevant financial disclosures.
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