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PCOS linked to increased risk of cardiometabolic and psychiatric complications in pregnancy
Women with PCOS have greater risk of perinatal and postpartum cardiometabolic and psychiatric complications is the result of the study.
Women with polycystic ovary syndrome (PCOS) are at a higher risk for metabolic and psychiatric comorbidities prior to pregnancy, cardiometabolic complications during pregnancy and cardiometabolic and psychiatric complications in the postpartum period is the finding of a new study. Dr Anuja Dokras, MD, PhD, director of the Penn Polycystic Ovary Syndrome Center at the University of Pennsylvania, Philadelphia presented the paper at the annual meeting of the American Society for Reproductive Medicine.
“Our findings do support the ACOG [American College of Obstetricians and Gynecologists] recommendations that women with PCOS should be considered a high-risk group, and during the postpartum period should be screened for cardiovascular as well as psychiatric comorbidities,” said Anuja Dokras, MD, PhD, director of the Penn Polycystic Ovary Syndrome Center at the University of Pennsylvania, Philadelphia, in her presentation.
Dr Dokras and colleagues performed a retrospective cohort study during 2000-2016 of patients aged 18-50 years, in the Optum claims database. They included women for a minimum of 6 months prior to conception, their entire pregnancy and at least 6 weeks following delivery. In total 42,391 women with PCOS and 795,480 women without PCOS in 50 U.S. states were included. The researchers looked at risk factors prior to pregnancy, such as depression, hypertension, hyperlipidemia, diabetes, obesity, smoking, and use of assisted reproductive technology. During pregnancy, The researchers analyzed complications such as preterm birth, multiple gestations, cesarean section, gestational hypertension and diabetes, preeclampsia and eclampsia, and depression in addition to outcomes in the postpartum period, such as hypertensive complications, thrombotic disease, peripartum cardiomyopathy, heart failure, arterial complications, perinatal and postpartum depression.
The researchers found that women with PCOS were more likely to have depression (4% vs 3%), diabetes (5% vs 1%), hypertension (6% vs 3%) and obesity (15% vs 5%) compared to women without PCOS (p<0.001 for all). Also, they had a higher prevalence of gestational diabetes (24% vs 13%), gestational hypertension (14% vs 8%) and antepartum preeclampsia (5% vs 3%) than women without PCOS (p<0.001). In multivariable models, women with PCOS had a significantly higher odds of both perinatal and postpartum depression and postpartum preeclampsia and eclampsia compared to those without PCOS (Table). Postpartum results remained similar in planned sensitivity analyses in women with at least one year of pre-conception data, when including date of delivery in outcome definition and when varying the definition of perinatal and postpartum depression from the DSM-V criteria of 4 weeks postpartum to a commonly utilized literature length of one year postpartum.
For further reference log on to :
Dokras A, et al. ASRM 2019. Abstract O-93.
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