Pregnancy outcome in women with polycystic ovary syndrome in relation to second-trimester testosterone levels

REPRODUCTIVE BIOMEDICINE ONLINE

卷:42

Article

Valdimarsdottir, Ragnheidur¹  Wikstrom, Anna-Karin¹  Kallak, Theodora Kunovac¹  Elenis, Evangelia¹  Axelsson, Ove^1,2  Preissl, Hubert^3,4,5  Ubhayasekera, S. J. Kumari A.⁶  Bergquist, Jonas⁶  Poromaa, Inger Sundstrom¹ 

[1] Uppsala Univ, Dept Womens & Childrens Hlth, S-75185 Uppsala, Sweden

[2] Uppsala Univ, Ctr Clin Res Sormland, Eskilstuna, Sweden

[3] Univ Tubingen, German Ctr Diabet Res DZD eV, Inst Diabet Res & Metab Dis, Tubingen, Germany

[4] Univ Tubingen, German Ctr Diabet Res DZD eV, Helmholtz Ctr Munich, Tubingen, Germany

[5] Univ Hosp Tubingen, Dept Internal Med 4, Div Endocrinol Diabetol & Nephrol, Tubingen, Germany

[6] Uppsala Univ Uppsala, Dept Chem BMC Analyt Chem & Neurochem, Uppsala, Sweden

关键词: Birth weight;    Maternal metabolic factors;    Polycystic ovary syndrome;    Pregnancy complications;    Testosterone;   

DOI  :  10.1016/j.rbmo.2020.09.019

来源: Elsevier

【 摘 要 】

Research question: Do women with polycystic ovary syndrome (PCOS) have higher testosterone levels during pregnancy and what role does high testosterone play in the development of obstetric complications? Design: Retrospective cohort study from Uppsala University Hospital, Sweden. The study population consisted of women with PCOS (n = 159) and a comparison group of women without PCOS matched for body mass index (n = 320). Plasma testosterone levels were measured in the early second trimester by liquid chromatography with tandem mass spectrometry, and women with PCOS were grouped into tertiles according to their testosterone levels. Possible associations with obstetric complications, maternal metabolic factors and offspring birth weight were explored by multivariable logistic and linear regression models. Results: Compared with women who do not have PCOS, women with PCOS had higher total testosterone (median 1.94, interquartile range [IQR] 1.21-2.64 versus 1.41, IQR 0.89-1.97; P < 0.001), and free androgen index (median 0.25, IQR 0.15-0.36 versus 0.18, IQR 0.11-0.28; P < 0.001). Women with PCOS who had the highest levels of testosterone had increased risk for preeclampsia, even when adjusted for age, parity, country of birth and smoking (adjusted OR 6.16, 95% 011.82 to 20.91). No association was found between high testosterone in women with PCOS and other obstetric complications. Conclusions: Women with PCOS have higher levels of total testosterone and free androgen index during pregnancy than women without PCOS matched for body mass index. Preliminary evidence shows that women with PCOS and the highest maternal testosterone levels in early second trimester had the highest risk of developing preeclampsia. This finding, however, is driven by a limited number of cases and should be interpreted with caution.

【 授权许可】

Free