Coagulation And Fibrinolytic Indices During The First Trimester Of Pregnancy In Women With Polycystic Ovary Syndrome: A Preliminary Study

Objective: To discuss the differences of coagulation and fibrinolytic indice duringthe first trimester of pregnancy between women with polycystic ovary syndrome (PCOS)and healthy women and between pregnant women with PCOS (obesity and non-obeisty)and healthy pregnant women (obesity and non-obeisty) and analyse the effects of PCOSand obesity and pregnancy on the levels of these hemostatic markers.Methods: A cross-sectional study was conducted in Beijing, China on women withPCOS (n=50), healthy women (n=50), pregnant women with PCOS (n=50) and healthypregnant women (n=50) at12weeks of pregnancy and healthy obesity pregnant women(n=25), healthy non-obesity pregnant women (n=25), obesity pregnant women withPCOS (n=25) and obesity pregnant women (n=25) with PCOS. The levels ofcoagulation factor VIII (FVIII) activity, coagulation factor X (FX) activity, vonWillebrand factor (vWF), plasminogen activator inhibitor1(PAI-1), tissueplasminogen activator (t-PA) and D-dimer were measured. Additionally, we alsodiscuss the effects of PCOS, pregnancy and obesity on these hemostatic markers usingthe two way ANOVA models.Results: In the comparison of four groups (women with PCOS, healthy women,pregnant women with PCOS and healthy pregnant women), after the adjustment of ageand BMI, comparing with non-pregnant women with PCOS and healthy pregnantwomen, the activity levels of FVIII and FX and the levels of vWF were significantlyhigher in pregnant women with PCOS compared with healthy pregnant women andnon-pregnant women with PCOS (P<0.05). The level of D-dimer was significantly higher in pregnant women with PCOS compared with non-pregnant women with PCOS(P<0.05). The levels of PAI-1and t-PA were significantly higher in pregnant womenwith PCOS compared with healthy pregnant women (P<0.05), however, the differencesof PAI-1and t-PA were not significant between non-pregnant and pregnant women withPCOS. The interaction between PCOS and pregnancy appears to exert effects oncoagulation factor VIII (FVIII) activity and coagulation factor X (FX) activity.In the comparison of four groups (obesity pregnant women with PCOS, non-obesity pregnant women with PCOS, obesity and non-obesity healthy pregnant women),the highest levels of FVIII activity, FX activity, PAI-1, t-PA, vWF and D-dimer are inthe obesity pregnant women with PCOS. After the adjustment of age, comparing withnon-obesity pregnant women with PCOS, the levels of FVIII activity, FX activity, PAI-1and t-PA were significantly higher in obesity pregnant women with PCOS (P<0.05).Comparing with obesity healthy pregnant women, the levels of FVIII activity, FXactivity, vWF were significantly higher in obesity pregnant women with PCOS (P<0.05). Comparing with non-obesity healthy pregnant women, the levels of FVIII activity,FX activity, vWF were significantly higher in non-obesity pregnant women withPCOS(P<0.05), however, the levels of D-dimer, PAI-1and t-PA were notsignificantly higher in non-obesity pregnant women with PCOS (P>0.05). Theinteraction between PCOS and obesity also seems to affect the level of vWF (P<0.05).Conclusions: Comparing with healthy pregnant women, the coagulation andfibrinolytic indice during the first trimester of pregnancy between women withpolycystic ovary syndrome (PCOS) were changed. The interaction between PCOS andpregnancy appears to exert effects on coagulation factor VIII (FVIII) activity andcoagulation factor X (FX) activity. Comparing with obesity healthy pregnant womenand non-obesity pregnant women with PCOS, the coagulation and fibrinolytic indice during the first trimester of pregnancy in women with PCOS were changed. Theinteraction between PCOS and obesity also seems to affect the level of vWF. Pregnantwomen with PCOS, especially women who are obese, are observed to be in a more pro-hemostatic state during the first trimester.