Late pregnancy complications in polycystic ovarian syndrome.

Gestational diabetes mellitus and new-onset hypertension, which includes gestational hypertension and pre-eclampsia, are common complications of pregnancy. Many features of the insulin resistance syndrome have been associated with these conditions. These include glucose intolerance, hyperinsulinemia, hypertension, obesity, and lipid abnormalities. Other accompanying abnormalities may include elevated serum levels of leptin, TNFalpha, plasminogen activator inhibitor-1 and testosterone. The establishment of these features before the onset of gestational diabetes mellitus and hypertension in pregnancy suggests that insulin resistance or associated abnormalities may play a role in these disorders. These observations suggest that therapeutic interventions to reduce insulin resistance may lower the risk of both gestational diabetes mellitus and hypertension in pregnancy.