Low-grade chronic inflammation in pregnant women with polycystic ovary syndrome: A prospective controlled clinical study

Stefano Palomba, Angela Falbo, Giuseppe Chiossi, Francesco Orio, Achille Tolino, Annamaria Colao, Giovanni Battista La Sala, Fulvio Zullo

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Context: Polycystic ovary syndrome (PCOS) and pregnancy are conditions characterized by an increased low-grade chronic inflammation state. A higher incidence of pregnancy complications has been detected in pregnant PCOS women. Objective: The objective of the study was to test the hypothesis that the low-grade chronic inflammation state typical of PCOS patients persists during gestation and is exacerbated by pregnancy and contributes to the increased risk of obstetric/neonatal complications. Design: This was a prospective controlled clinical study. Setting: The study was conducted at the Academic Department of Obstetrics and Gynecology of the "Pugliese-Ciaccio" Hospital of Catanzaro (Catanzaro, Italy). Patients: One hundred fifty pregnant PCOS women and 150 age- and body mass index-matched healthy pregnant controls participated in the study. Interventions: Interventions included serial clinical, biochemical, and ultrasonographic assessments before and throughout pregnancy. Main Outcome Measures: Serum levels of white blood cell count (WBC), C-reactive protein (CRP), and ferritin were measured. Results: Pregnant women with PCOS had higher WBC, CRP, and ferritin levels at study entry and at all gestational ages than controls. Changes in serum WBC and ferritin levels were significantly higher in PCOS than in controls starting from the 12thweekof gestation whereas those in CRP from the 20th week of gestation. By multivariable Cox proportional hazard analysis, in the PCOS group, a significant association with the risk of adverse obstetric/neonatal outcomes was found for WBC [hazard ratio (HR) 1.52, 95% confidence interval (CI) 1.31-1.64; P = .010], CRP (HR 1.19, 95% CI 1.06-1.34; P = .019), and ferritin levels (HR 1.12, 95% CI 1.03-1.26; P = .011). Conclusions: In PCOS patients, the low-grade chronic inflammation persists during gestation and is exacerbated by pregnancy, and it is associated with adverse pregnancy outcomes.

Original languageEnglish (US)
Pages (from-to)2942-2951
Number of pages10
JournalJournal of Clinical Endocrinology and Metabolism
Volume99
Issue number8
DOIs
StatePublished - 2014
Externally publishedYes

Fingerprint

Polycystic Ovary Syndrome
Obstetrics
Ferritins
C-Reactive Protein
Pregnant Women
Hazards
Blood
Inflammation
Pregnancy
Leukocyte Count
Gynecology
Confidence Intervals
Cells
Hospital Obstetrics and Gynecology Department
Pregnancy Complications
Clinical Studies
Pregnancy Outcome
Serum
Italy
Gestational Age

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism

Cite this

Low-grade chronic inflammation in pregnant women with polycystic ovary syndrome : A prospective controlled clinical study. / Palomba, Stefano; Falbo, Angela; Chiossi, Giuseppe; Orio, Francesco; Tolino, Achille; Colao, Annamaria; La Sala, Giovanni Battista; Zullo, Fulvio.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 99, No. 8, 2014, p. 2942-2951.

Research output: Contribution to journalArticle

Palomba, Stefano ; Falbo, Angela ; Chiossi, Giuseppe ; Orio, Francesco ; Tolino, Achille ; Colao, Annamaria ; La Sala, Giovanni Battista ; Zullo, Fulvio. / Low-grade chronic inflammation in pregnant women with polycystic ovary syndrome : A prospective controlled clinical study. In: Journal of Clinical Endocrinology and Metabolism. 2014 ; Vol. 99, No. 8. pp. 2942-2951.
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abstract = "Context: Polycystic ovary syndrome (PCOS) and pregnancy are conditions characterized by an increased low-grade chronic inflammation state. A higher incidence of pregnancy complications has been detected in pregnant PCOS women. Objective: The objective of the study was to test the hypothesis that the low-grade chronic inflammation state typical of PCOS patients persists during gestation and is exacerbated by pregnancy and contributes to the increased risk of obstetric/neonatal complications. Design: This was a prospective controlled clinical study. Setting: The study was conducted at the Academic Department of Obstetrics and Gynecology of the {"}Pugliese-Ciaccio{"} Hospital of Catanzaro (Catanzaro, Italy). Patients: One hundred fifty pregnant PCOS women and 150 age- and body mass index-matched healthy pregnant controls participated in the study. Interventions: Interventions included serial clinical, biochemical, and ultrasonographic assessments before and throughout pregnancy. Main Outcome Measures: Serum levels of white blood cell count (WBC), C-reactive protein (CRP), and ferritin were measured. Results: Pregnant women with PCOS had higher WBC, CRP, and ferritin levels at study entry and at all gestational ages than controls. Changes in serum WBC and ferritin levels were significantly higher in PCOS than in controls starting from the 12thweekof gestation whereas those in CRP from the 20th week of gestation. By multivariable Cox proportional hazard analysis, in the PCOS group, a significant association with the risk of adverse obstetric/neonatal outcomes was found for WBC [hazard ratio (HR) 1.52, 95{\%} confidence interval (CI) 1.31-1.64; P = .010], CRP (HR 1.19, 95{\%} CI 1.06-1.34; P = .019), and ferritin levels (HR 1.12, 95{\%} CI 1.03-1.26; P = .011). Conclusions: In PCOS patients, the low-grade chronic inflammation persists during gestation and is exacerbated by pregnancy, and it is associated with adverse pregnancy outcomes.",
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T1 - Low-grade chronic inflammation in pregnant women with polycystic ovary syndrome

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AU - Palomba, Stefano

AU - Falbo, Angela

AU - Chiossi, Giuseppe

AU - Orio, Francesco

AU - Tolino, Achille

AU - Colao, Annamaria

AU - La Sala, Giovanni Battista

AU - Zullo, Fulvio

PY - 2014

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N2 - Context: Polycystic ovary syndrome (PCOS) and pregnancy are conditions characterized by an increased low-grade chronic inflammation state. A higher incidence of pregnancy complications has been detected in pregnant PCOS women. Objective: The objective of the study was to test the hypothesis that the low-grade chronic inflammation state typical of PCOS patients persists during gestation and is exacerbated by pregnancy and contributes to the increased risk of obstetric/neonatal complications. Design: This was a prospective controlled clinical study. Setting: The study was conducted at the Academic Department of Obstetrics and Gynecology of the "Pugliese-Ciaccio" Hospital of Catanzaro (Catanzaro, Italy). Patients: One hundred fifty pregnant PCOS women and 150 age- and body mass index-matched healthy pregnant controls participated in the study. Interventions: Interventions included serial clinical, biochemical, and ultrasonographic assessments before and throughout pregnancy. Main Outcome Measures: Serum levels of white blood cell count (WBC), C-reactive protein (CRP), and ferritin were measured. Results: Pregnant women with PCOS had higher WBC, CRP, and ferritin levels at study entry and at all gestational ages than controls. Changes in serum WBC and ferritin levels were significantly higher in PCOS than in controls starting from the 12thweekof gestation whereas those in CRP from the 20th week of gestation. By multivariable Cox proportional hazard analysis, in the PCOS group, a significant association with the risk of adverse obstetric/neonatal outcomes was found for WBC [hazard ratio (HR) 1.52, 95% confidence interval (CI) 1.31-1.64; P = .010], CRP (HR 1.19, 95% CI 1.06-1.34; P = .019), and ferritin levels (HR 1.12, 95% CI 1.03-1.26; P = .011). Conclusions: In PCOS patients, the low-grade chronic inflammation persists during gestation and is exacerbated by pregnancy, and it is associated with adverse pregnancy outcomes.

AB - Context: Polycystic ovary syndrome (PCOS) and pregnancy are conditions characterized by an increased low-grade chronic inflammation state. A higher incidence of pregnancy complications has been detected in pregnant PCOS women. Objective: The objective of the study was to test the hypothesis that the low-grade chronic inflammation state typical of PCOS patients persists during gestation and is exacerbated by pregnancy and contributes to the increased risk of obstetric/neonatal complications. Design: This was a prospective controlled clinical study. Setting: The study was conducted at the Academic Department of Obstetrics and Gynecology of the "Pugliese-Ciaccio" Hospital of Catanzaro (Catanzaro, Italy). Patients: One hundred fifty pregnant PCOS women and 150 age- and body mass index-matched healthy pregnant controls participated in the study. Interventions: Interventions included serial clinical, biochemical, and ultrasonographic assessments before and throughout pregnancy. Main Outcome Measures: Serum levels of white blood cell count (WBC), C-reactive protein (CRP), and ferritin were measured. Results: Pregnant women with PCOS had higher WBC, CRP, and ferritin levels at study entry and at all gestational ages than controls. Changes in serum WBC and ferritin levels were significantly higher in PCOS than in controls starting from the 12thweekof gestation whereas those in CRP from the 20th week of gestation. By multivariable Cox proportional hazard analysis, in the PCOS group, a significant association with the risk of adverse obstetric/neonatal outcomes was found for WBC [hazard ratio (HR) 1.52, 95% confidence interval (CI) 1.31-1.64; P = .010], CRP (HR 1.19, 95% CI 1.06-1.34; P = .019), and ferritin levels (HR 1.12, 95% CI 1.03-1.26; P = .011). Conclusions: In PCOS patients, the low-grade chronic inflammation persists during gestation and is exacerbated by pregnancy, and it is associated with adverse pregnancy outcomes.

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