Risk factors of preeclampsia in infertile Chinese women with polycystic ovary syndrome: a prospective cohort study
Hexia Xia (CN)
[Xia] Obstetrics and Gynecology Hospital of Fudan University
Objective We aim to explore the preconception risk factors of preeclampsia (PE) in polycystic ovary syndrome (PCOS) women. Methods Between January 2010 and December 2014, a prospective cohort study was conducted. Patients and interventions Infertile Chinese women with PCOS who got singleton pregnancy by ovulation induction were enrolled and then followed up until 6 weeks after delivery. The patients’ preconception physical, endocrine and metabolic features were assessed. Main outcome measures The morbidity of PE was determined during the pregnancy. Logistic regression analysis and receiver operating characteristic (ROC) analysis were both applied to explore the predictive value of risk factors. Results Fifteen (16.3%) women were diagnosed with PE among the 92 infertile Chinese patients with PCOS. PCOS patients who subsequently developed PE presented a lower level of sex hormone binding globulin (SHBG) before pregnancy (P < 0.05 after BMI adjusted). Logistic regression analysis showed that preconception SHBG, INS120 levels and BMI were three independent risk factors of PE (OR: 0.981, 95%CI: 0.964-0.998, P =0.027, OR: 1.011, 95% CI: 1.000- 1.021, P = 0.048 and OR: 1.249, 95%CI: 0.992-1.572, P =0.059). Receiver operative characteristic (ROC) analysis identified the risk value of pre-pregnancy SHBG, INS 120 level and BMI (AUC 0.788, 0.686, and 0.697). Conclusion Low SHBG levels, overweight/obesity and hyperinsulinism before pregnancy might be correlated with subsequent development of PE in infertile Chinese women with PCOS.