Preeclampsia Prediction in Pcos Women: Identifying Biomarkers for Early Intervention and Improved Pregnancy Outcomes

Abstract

Objective: To identify clinical, metabolic, inflammatory, and angiogenic biomarkers associated with subsequent development of preeclampsia among pregnant women with polycystic ovary syndrome (PCOS).

Methods: A prospective observational cohort study of 202 women with PCOS during pregnancy. Demographic, anthropometric, obstetric, metabolic, inflammatory, and angiogenic parameters were evaluated at enrollment and followed until delivery. Appropriate comparative tests and logistic regression were used to determine association with preeclampsia. Receiver operating characteristic (ROC) analysis was used to evaluate predictive performance.

Results: In 17 (8.4%) participants, preeclampsia occurred. Women with preeclampsia also had significantly higher BMI, blood pressure, fasting glucose, HOMA-IR, triglycerides, and hs-CRP; lower PlGF; and higher sFlt-1 and sFlt-1/PlGF. HOMA-IR ≥2.5, hs-CRP >5 mg/L, lower PlGF, and higher sFlt-1/PlGF ratio were independent predictors determined by multivariable analysis. The sFlt-1/PlGF ratio had an AUC of 0.889. A combined model of HOMA-IR, hs-CRP, PlGF, and sFlt-1/PlGF had an AUC of 0.931, and a sensitivity and specificity of 88.2% and 88.1%, respectively.

Conclusion: Women with PCOS who presented with metabolic, inflammatory, and angiogenic disorders had a subsequent risk of preeclampsia. A combination of biomarkers showed good predictive performance and could help initiate earlier risk stratification and more frequent antenatal monitoring.