Hormonal Disorder Linked to Pregnancy Complications

Chronic inflammation in PCOS worsened during pregnancy and associated with adverse pregnancy events

(RxWiki News) Women with polycystic ovary syndrome tend to have more complications in pregnancy — an observation that led researchers to look for a possible reason.

Polycystic ovary syndrome (PCOS) is marked by chronic inflammation, a condition where the immune system is working overtime to heal the body.

A research team recently set out to see if there was a link between chronic inflammation in PCOS and the pregnancy complications experienced by some women with PCOS.

This team's findings showed that chronic inflammation in PCOS patients got worse during pregnancy and was tied to an increased risk for pregnancy complications that included high blood pressure, pregnancy-associated diabetes and giving birth to babies that were either smaller or larger than normal.

"See an obstetrician for prenatal care."

The lead author of this study was Stefano Palomba, MD, from the Obstetrics and Gynecology Unit at the Istituto di Ricovero e Cura a Carettere Scientifico in Reggio Emilia, Italy.

The research team compared 150 pregnant women with PCOS to 150 healthy pregnant women. These researchers measured signs of chronic inflammation and looked at pregnancy complications and outcomes. White blood cell counts and serum C-reactive protein (CRP) were measured as signs of chronic inflammation.

Measurements were taken at the beginning of the study and at 12, 20 and 32 weeks of pregnancy.

The researchers found that white blood cell counts and CRP levels rose in both the PCOS patients and in the healthy women throughout their pregnancy, but white blood cell counts and CRP levels were significantly higher in the PCOS patients than in the healthy women.

Miscarriages and high blood pressure were more common in the group of PCOS patients than in the healthy women. Miscarriages occurred in 24 PCOS patients and eight healthy women. High blood pressure was seen in 19 PCOS patients and eight healthy women.

Diabetes during pregnancy, preeclampsia (high blood pressure and protein in the urine during pregnancy) and excessive bleeding after delivery were also significantly more common in women with PCOS than in the healthy women.

More small babies and large babies were born to women with PCOS than to the healthy women. Small and large babies were defined as those babies whose measurements of height, weight and head size were larger or smaller than the measurements of 90 percent of infants of the same age and gender.

Dr. Palomba and team reported that 20 women with PCOS had small babies, compared with nine of the healthy women, and that 16 PCOS patients had large babies, compared with two of the healthy women.

The authors wrote that the change in the inflammatory markers (white blood cell count and CRP levels) suggested that “pregnancy enhances the chronic low grade inflammation typical of the syndrome.”

“Other studies have identified a connection between inflammation biomarkers and pregnancy complications such as pre-eclampsia and gestational diabetes. The abnormal inflammation seen in women with PCOS may be a factor in the development of these conditions," Dr. Palomba said in a press release.

This study was published online in May in the Journal of Clinical Endocrinology & Metabolism.

The authors declared no conflicts of interest.

Review Date: 
May 29, 2014