Human Reproduction, Vol. 16, No. 7, 1537,
July 2001
© 2001 European Society of Human Reproduction and Embryology
Letters to the editor |
Obstetric outcome in women with polycystic ovarian syndrome
Department of Obstetrics and Gynaecology, PO Box 140, 00029 HUS, Finland, E-mail: aila.tiitinen{at}hus.fi
Dear Sir,
We would like to thank Drs Kashyap and Claman for their interest and comments on our paper. In our study, we were not able to show an association between polycystic ovarian syndrome (PCOS) and pre-eclampsia, but we showed that PCOS slightly increased the risk for gestational diabetes mellitus (GDM) (Mikola et al., 2001
).
Our original hypothesis was that, indeed, PCOS and pre-eclampsia would be associated. Earlier studies from our clinic showed that women with prior pre-eclampsia were hyperinsulinaemic and hyperandrogenic 17 years later (Laivuori et al., 1996, 1998), both of these endocrine findings being markers for PCOS. We believe that the conflicting results can be explained by different patient populations and different control populations. We compared PCOS patients with a normal background pregnant population, whereas Kashyap and Claman (2000) compared PCOS to another patient group with anovulatory infertility. It may be possible that their control group represented women who have a lower than normal risk for pre-eclampsia. Due to the retrospective nature of our study, we could not look specifically at the occurrence of only pregnancy-induced hypertension. Also, our patient group presents the PCOS patient population as whole, not only the most severe form. Moreover, we were careful to find the independent effect of PCOS on GDM and pre-eclampsia by using multiple logistic regression variables.
We agree with the conclusion that pregnant PCOS patients should be followed carefully for the occurrence of various pregnancy complications, including GDM and hypertension.
References
Kashyap, S. and Claman, P. (2000) Polycystic ovarian syndrome is an important risk factor for the development of pregnancy induced hypertension. J. Rep. Med., 45, 991–994.
Laivuori, H., Tikkanen, M.J. and Ylikorkala O. (1996) Hyperinsulinemia 17 years after pre-eclamptic first pregnancy. J. Clin. Endocrinol. Metab., 81, 2908–2911.
Laivuori, H., Kaaja, R., Rutanen, E.-M. et al. (1998) Evidence of high circulating testosterone in women with prior pre-eclampsia. J. Clin. Endocrinol. Metab., 83, 344–347.
Mikola, M., Hiilesmaa, V., Halttunen, M. et al. (2001) Obstetric outcome in women with polycystic ovarian syndrome. Hum. Reprod., 16, 226–229.
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