Evaluation of the relationship between thrombophilic factors and pregnancy complications in women with polycystic ovarian syndrome

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Abstract

Background and Objective: Pregnancy-associated changes in hemostatic and fibrinolytic proteins establish a hypercoagulable state and significant risk venous thromboembolism (VTE) events. Polycystic ovarian syndrome (PCOS) is associated with insulin-induced plasminogen activator inhibitor-1 (PAI-1) elevation, the most potent inhibitor of fibrinolysis. In addition to hypofibrinolysis due to increased PAI-1 levels, miscarriage and complications in pregnancy are probably a result of prothrombotic effects of thrombophilia in PCOS patients. The aim of this study was evaluation of thrombophilia tests and relationship between them and abortion in PCOS patients. Materials and Methods: This analytic cohort study was performed on 123 women with PCOS as the case group, and 73 women with no PCOS as the control group. The two groups had referred to the Infertility Clinic for treatment. Thrombophilia factors including protein C, antithrombin III and APC-R were measured for both groups. A study was also done on the history of some complications such as abortion, IUGR, placenta abruption, still-birth and preeclampsia in two groups and their relationship with thrombophilia factors. Data were analyzed using independent t-test, chi-square and fisher exact tests. Results: There was no statistically significant difference in protein C, antithrombinIII and .APC-R between the two groups (p=0.602, p=0.756 and p=0.603 respectively). Although abortion and IUGR rates in women with PCOS were significantly higher than healthy women )p=0.026), but there was no statistically significant difference between abortion and IUGR with thrombophilic factors (0.549). Conclusion: There was statistically a significant difference of history of pregnancy complications between PCOS and non-PCOS groups, but there was no statistically significance difference in thrombophilic factors and these factors with pregnancy complications between two groups.   

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