| Summary: | Abstract. Objective. To investigate the prevalence of hypertensive disorders of pregnancy (HDP), and the respective roles of PCOS, obesity, lifelong weight gain (WG) and hyperandrogenemia in the disease development by age 46. Methods. The Northern Finland Birth Cohort 1966, with follow-up at ages 14, 31 and 46, including women with (n=408) and without (n=3373) HDP diagnosis. HDP diagnosis was combined from the questionnaire data at age 46, hospital discharge records and Finnish Medical Birth Registers. Women with both oligo-amenorrhea and hirsutism at age 31 or with PCOS diagnosis by age 46 (n=279) were compared with the women without PCOS (n=1577). Results. Women with PCOS had an increased HDP risk (odds ratio [OR]=1.56 [95%CI:1.03–2.37]), but the association disappeared after adjusting for BMI at age 31. The risk for HDP was not increased among normal weight PCOS women. The increase of BMI (kg/m²) from age 14 to 31 was significantly greater in both PCOS (median (interquartile range): 5.94(3.69;11.1), p<0.001) and non-PCOS (4.89(3.21;7.57), p<0.001) women with HDP and also in PCOS women without HDP (4.59(2.40;7.54), p=0.009) compared to non-PCOS without HDP. Among women with PCOS, BMI increase was greater in women with than without HDP (5.94(3.69;11.1) vs 4.59(2.40;7.54), p=0.015). Hyperandrogenemia at ages 31 or 46 did not associate with HDP (OR=1.44 [95%CI: 0.98–2.11]). Conclusion: Obesity and weight gain from adolescence to age 46, but not PCOS per se or hyperandrogenemia, were associated with an increased risk of HDP. There was a strong synergistic association of PCOS and obesity regarding HDP risk.
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