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Hum. Reprod. Advance Access published online on March 16, 2007
Human Reproduction, doi:10.1093/humrep/dem028
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© The Author 2007. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Vascular dysfunction during pregnancy in women with polycystic ovary syndrome

Shan Hu1, Andrew Leonard1, Alex Seifalian2 and Paul Hardiman1,3

1 Academic Department of Obstetrics and Gynaecology London UK 2 Vascular Haemodynamic Unit, Department of Surgery, Royal Free and University College Medical School, London, UK

3 To whom correspondence should be addressed at: Academic Department of Obstetrics and Gynaecology, Royal Free and University College Medical School, The Royal Free Hospital, Pond Street, London NW3 2PF, UK. Tel.: +44 20 7830 2435; Fax: +44 20 7830 2261; E-mail p.hardiman{at}medsch.ucl.ac.uk

BACKGROUND: An association has been proposed between polycystic ovary syndrome (PCOS) and pregnancy-induced hypertensive disorders. Ambulatory blood pressure and carotid artery elasticity were therefore prospectively investigated in matched PCOS and control pregnancies.

METHODS: Twenty two PCOS–control subject pairs with singleton pregnancies, matched for age, body mass index, parity and ethnicity, were recruited in the first trimester (T1, 11–13 weeks). Ambulatory blood pressure recording for 24 h and carotid artery ultrasound for elasticity estimation were performed in T1 and in the second (T2, 22–24 weeks) and third (T3, 32–34 weeks) trimesters.

RESULTS: At nearly all time points during gestation, ambulatory systolic, diastolic and mean arterial pressures were elevated in PCOS versus control pregnancies. Carotid artery stiffness index was greater and compliance was less in PCOS pregnancies compared with controls. Differences in night-time systolic pressure and carotid artery elasticity were greatest in T3. PCOS also increased the incidence of pregnancy-induced hypertension (6 of 22 cases versus 0 of 22 in controls; P = 0.011).

CONCLUSIONS: Pregnant women with PCOS have higher baseline ambulatory blood pressure and impaired arterial elasticity, suggestive of disturbed vascular adaptation to pregnancy.

Key words: arterial function/blood pressure/heart rate/polycystic ovary syndrome/pregnancy-induced hypertension

Submitted on August 10, 2006; resubmitted on November 6, 2006; accepted on December 1, 2006.


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