Cardiovascular function in pregnant women with polycystic ovary syndrome.
Doctoral thesis, UCL (University College London).
An association has been proposed between polycystic ovary syndrome (PCOS) and hypertensive disorders of pregnancy, with an increasing body of evidence indicating that PCOS may have significant implications for pregnancy outcomes and long-term health of a woman and her offspring. Whether PCOS itself or the associated conditions, like obesity and fertility treatment, are responsible for these increased risks is a continuing matter of debate. Ambulatory blood pressure and carotid artery elasticity were therefore prospectively investigated in matched PCOS and control pregnancies. 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 and intima media thickness (IMT) were performed in T1 and in the second (T2, 22–24 weeks) and third (T3, 32–34 weeks) trimesters. In addition, endothelial function was examined using post-occlusive reactive hyperaemia (PORH). 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 hypertensive disorders of pregnancy. IMT was also higher in PCOS group in all trimesters of pregnancy but there was no significant difference in PORH results in both groups throughout pregnancy. Pregnant women with PCOS have higher baseline ambulatory blood pressure and impaired arterial elasticity, suggestive of disturbed vascular adaptation to pregnancy. The IMT was also higher in pregnant PCOS women, consistent with the notion of increased cardiovascular co-morbities in PCOS.
|Title:||Cardiovascular function in pregnant women with polycystic ovary syndrome|
|Additional information:||Permission for digitisation not received|
|Keywords:||PCOS, carotid elasticity, stiffness index, compliance, intima media thickness, post-occlusive reactive hyperaemia|
|UCL classification:||UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Women's Health|
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