Pregnancy outcome in women with polycystic ovary syndrome in relation to second trimester testosterone levels: Polycystic ovary syndrome, testosterone and pregnancy

Research Question Do women with PCOS have higher testosterone levels during pregnancy and what role has high testosterone for the development of obstetric complications? Design Retrospective cohort study from Uppsala University Hospital, Sweden. The study population consisted of women with PCOS (n = 159) and a comparison group of body mass index (BMI)-matched non-PCOS women (n = 320). Plasma testosterone levels were measured in the early second trimester by LC-MS/MS, and women with PCOS were grouped in tertiles according to their testosterone levels. Possible associations to obstetric complications, maternal metabolic factors and offspring birthweight, were explored by multivariable logistic and linear regression models. Results Compared to non-PCOS women, women with PCOS had higher total testosterone [median 1.94 (IQR 1.21 – 2.64) vs. 1.41 (IQR 0.89 – 1.97), p Conclusions Women with PCOS have higher levels of total testosterone and free androgen index during pregnancy than BMI-matched non-PCOS women. We found preliminary evidence that women with PCOS and the highest maternal testosterone levels in early second trimester, had the highest risk of developing preeclampsia. However, this finding is driven by few cases and should be interpreted with caution.