Vascular dysfunction during pregnancy in women with polycystic ovary syndrome

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.