Predictors of hypertensive disorders in pregnancy in women with and without polycystic ovary syndrome: The Australian Longitudinal Study of Women's Health.

ABSTRACT

OBJECTIVES: A higher risk of hypertensive disorders in pregnancy (HDP) is frequently reported in women with polycystic ovary syndrome (PCOS). These women, however, have a higher risk profile for HDP compared with women without PCOS. The aim of this study was to elucidate the impact of PCOS per se on the incidence of HDP through post hoc subgroup analyses of the Australian Longitudinal Study on Women's Health by level of risk. DESIGN: Longitudinal study. PATIENTS Of a total of 14,247 participants, 5838 women met the inclusion criteria. Eligible women were required to report PCOS and HDP status in at least one pregnancy within the study. MEASUREMENTS Included risk factors were age, body mass index, country of birth, parity, multiple pregnancy, subfertility, infertility treatment (hormonal vs. in vitro fertilization), gestational diabetes (GDM), family history of GDM and socioeconomic status. Longitudinal association between PCOS and HDP was assessed the using Cox proportional hazard regression with Efron's method. RESULTS: While PCOS was associated with a higher incidence of HDP in a univariate model [hazard ratio (HR) 1.34, 95% confidence interval (CI) 1.05, 1.72], the significance was not retained after adjustment for risk factors [HR 1.19, 95% CI 0.79, 1.79]. However in multivariate analysis of subgroups, PCOS remained significantly associated with higher risk of HDP in non-obese women only [HR 1.77, 95% CI 1.11, 2.82]. CONCLUSIONS: Higher risk of HDP in PCOS is likely related to risk factors other than PCOS.