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Predictors of hypertensive disorders in pregnancy in women with and without polycystic ovary syndrome: The Australian Longitudinal Study of Women's Health
Author(s) -
Bahri Khomami Mahnaz,
Earnest Arul,
Loxton Deborah,
Teede Helena J.,
Joham Anju E.
Publication year - 2021
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.14451
Subject(s) - polycystic ovary , medicine , hazard ratio , pregnancy , obstetrics , gestational diabetes , body mass index , proportional hazards model , gynecology , longitudinal study , infertility , diabetes mellitus , confidence interval , endocrinology , gestation , insulin resistance , biology , genetics , pathology
Abstract Objectives A higher risk of hypertensive disorders in pregnancy (HDP) is frequently reported in women with polycystic ovary syndrome (PCOS). These women, however, have a higher risk profile for HDP compared with women without PCOS. The aim of this study was to elucidate the impact of PCOS per se on the incidence of HDP through post hoc subgroup analyses of the Australian Longitudinal Study on Women's Health by level of risk. Design Longitudinal study. Patients Of a total of 14,247 participants, 5838 women met the inclusion criteria. Eligible women were required to report PCOS and HDP status in at least one pregnancy within the study. Measurements Included risk factors were age, body mass index, country of birth, parity, multiple pregnancy, subfertility, infertility treatment (hormonal vs. in vitro fertilization), gestational diabetes (GDM), family history of GDM and socioeconomic status. Longitudinal association between PCOS and HDP was assessed the using Cox proportional hazard regression with Efron's method. Results While PCOS was associated with a higher incidence of HDP in a univariate model [hazard ratio (HR): 1.34, 95% confidence interval (CI): 1.05, 1.72], the significance was not retained after adjustment for risk factors [HR: 1.19, 95% CI: 0.79, 1.79]. However in multivariate analysis of subgroups, PCOS remained significantly associated with higher risk of HDP in non‐obese women only [HR: 1.77, 95% CI: 1.11, 2.82]. Conclusions Higher risk of HDP in PCOS is likely related to risk factors other than PCOS.