Changes in serum cytokines throughout pregnancy in women with polycystic ovary syndrome.

Context Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with low-grade inflammation and increased incidence of pregnancy complications, but its influence on the maternal immune system in pregnancy is unknown. Longitudinal serum cytokine profiling is a sensitive measure of the complex immunological dynamics of pregnancy. Objective Determine the immunological dynamics of serum cytokines throughout pregnancy in women with PCOS and compare it to pregnancy in women without PCOS. Design and setting A post hoc analysis of longitudinal serum samples from two randomized, placebo-controlled multicenter studies of pregnant women with PCOS and two studies of pregnant women without PCOS. Participants Pregnant women with PCOS (n = 358) and without PCOS (n = 258, controls) provided 1752 serum samples from four time points in pregnancy (weeks 10, 19, 32, 36). Main outcome measures Maternal serum levels of 22 cytokines and C-reactive protein (CRP) at four time points in pregnancy. Results Women with PCOS showed marked immunological changes in serum cytokines throughout pregnancy. Compared to controls, women with PCOS showed higher levels of 17 cytokines and CRP at week 10 of pregnancy and a distinct cytokine development throughout pregnancy. The immunological dynamics in women with PCOS was significantly affected by maternal BMI, smoking and fetal sex. Conclusion Pregnancy in women with PCOS was associated with a strong early mobilization of inflammatory and other serum cytokines persisting throughout pregnancy, indicating a more activated immune status. These findings provide a novel basis for further study of PCOS and pregnancy complications.