Discussion
gestational diabetes, PCOS, normo-androgenic, hyperandrogenism, preeclampsia, hyperandrogenic
PREGNANCY-INDUCED HYPERTENSION, GESTATIONAL DIABETES, IUGR, EARLY PREGNANCY, PREGNANCY COMPLICATIONS, HYPERANDROGENISM, COMPLICATED PREGNANCIES, PATHOGENESIS, PREECLAMPSIA
The primary aim of this study was to investigate if s-PROK1 predicts pregnancy-induced hypertension, preeclampsia and late miscarriage/preterm delivery in women with PCOS. Previously, s-PROK1 was reported to be higher in the second and third trimesters in preeclamptic and IUGR pregnancies compared with uncomplicated pregnancies.We also investigated the impact of metformin on s-PROK1 and found lower levels by metformin use at conception, both with and without metformin use after inclusion, suggesting that metformin intake, especially in early pregnancy, might have a lowering effect on s-PROK1. However, participants were not randomised at this timepoint and the lower s-PROK1 at week 19 might reflect that those who used metformin at conception differed from those who did not. It is known that metformin decreases insulin levels, although the treatment does not seem to prevent gestational diabetes in PCOS women.A possible association between s-PROK1 and hyperandrogenism was also investigated. In contrast to our hypothesis, s-PROK1 was lower in women with hyperandrogenic phenotypes compared with normo-androgenic phenotype. However, there was no correlation between s-PROK1 and androgen levels at inclusion and week 19. Direct and indirect evidence support the role of androgens in the pathogenesis of placenta-related pregnancy complications.