Are Lean and Normal Weight Patients with Polycystic Ovarian Syndrome at Risk of Preeclampsia?

Background: We examined whether pregnant women with preeclampsia have an increased rate of pre-pregnancy polycystic ovary syndrome (PCOS). This study also evaluated whether the association, if any, was a result of preeclampsia and its relationship to PCOS or dependent upon concurrent obesity. Materials and Methods: In this study, 75 preeclampsia cases and 225 normotensive pregnant controls, matched for age and gravidity, were enrolled. A confirmation of pre-pregnancy PCOS was ascertained by recording medical history, along with a physical examination directed for signs and symptoms of PCOS, an ultrasound report of polycystic ovaries and laboratory tests which confirmed hyperandrogenism prior to pregnancy. Body mass index (BMI) was calculated for each patient. Participants were classified into two categories: lean/normal and obese according to a BMI < 25 or greater than 25.1, respectively. Chi-square, Student t test, Fisher-exact and Mann-Whitney tests were used to assess the differences between the groups in addition to the relationship between preeclampsia and PCOS. P values less than 0.05 were considered significant. Results: Age, gravidity and parity were not significantly different between cases and controls. However, a significant difference was found in gestational age and BMI between the groups. Additionally, preeclamptic patients more frequently suffered from pre-pregnancy PCOS than controls and a significant relationship was found between preeclampsia and previous PCOS, even amongst lean/normal weight patients. Conclusion: This study provides convincing evidence that a pre-pregnancy diagnosis of PCOS could predispose the patient to preeclampsia, regardless of a concomitant obesity risk factor.