Mid-pregnancy serum chemerin levels predict persistence of postpartum hypertension in patients with polycystic ovary syndrome

OBJECTIVE: Polycystic ovary syndrome (PCOS) is associated with a higher incidence of pregnancy-related hypertensive disorders (PHD), and an increased cardiometabolic risk. Chemerin, an adipokine involved in metabolic and inflammatory pathways, has been linked to both PCOS and PHD. This study was designed to test the hypothesis that mid-pregnancy maternal serum chemerin levels may predict persistent hypertension one year after delivery in women with PCOS and a history of PHD. DESIGN: Longitudinal cohort study. METHODS: Ninety-two patients with and without PCOS and previous PHD were studied 12 months after delivery. Serum chemerin concentrations were measured at 20 weeks of gestation. Logistic regression models were used to assess the association between chemerin and persistent hypertension. Receiver operating characteristic curve analysis evaluated predictive performance. RESULTS: Women with persistent hypertension exhibited significantly higher chemerin levels compared with normotensive women (median 31.3 vs. 20.1 ng/mL; P = 0.0003). Chemerin concentrations resulted independently associated with persistent hypertension (adjusted odds ratio 6.66 per 10 ng/mL; 95% CI 2.21-20.07; P = 0.0007). Among women with PCOS, a higher chemerin threshold (∼32.3 ng/mL) provided a positive predictive value of 57.1% and a negative predictive value of 82.9%. CONCLUSIONS: Mid-pregnancy chemerin levels independently predict persistent hypertension after delivery in patients with PCOS and prior PHD.