This article was originally published on practicalcardiology.com.
According to a new study, women with polycystic ovary syndrome (PCOS) are at increased risk of cardiovascular complications during childbirth hospitalizations than their counterparts without a common endocrine disorder.
Led by researchers at Johns Hopkins University School of Medicine, the study results, which are based on data from the national sample of hospitalized patients from 2002 to 2019, provide insight into the risk of complications cardiovascular events in women with PCOS during childbirth hospitalizations in the United States, suggesting PCOS was an independent predictor of increased risk for multiple complications, including preeclampsia, eclampsia, peripartum cardiomyopathy, and heart failure.
“Often, women with PCOS are understandably concerned about the immediate effects, such as irregular menstrual cycle, excessive hair growth, weight gain, and acne. However, long-term cardiovascular complications are also a serious concern” , said study researcher Erin Michos, MD, an associate professor of medicine at Johns Hopkins University School of Medicine, in a Johns Hopkins Medicine statement.
Although it is the most common endocrine disorder in women of childbearing age, PCOS represents an often overlooked aspect of women’s health in modern medicine. With this in mind, the researchers sought to provide clinicians with an overview of current trends, outcomes, and predictors of cardiovascular complications in women with PCOS during childbirth hospitalizations in the United States. To do this, the investigators designed their study as a retrospective analysis of National Inpatient Sample (NIS) data in cycles that occurred from 2002 to 2019. Using ICD-9 and ICD-19 codes, investigators identified 73,385,669 weighted hospitalizations.
After excluding those under 18, the overall study cohort included 71,436,308 weight-related hospitalizations for inclusion in their analyses. Of these, 195,675 had a diagnosis of PCOS. Compared to women without PCOS, women with PCOS had a higher median age (28 [24-32] against 31 [27-34] years; P P for all<.01>
The primary outcomes of interest for the analyzes were preeclampsia, peripartum cardiomyopathy, and heart failure. Secondary outcomes of those interested included eclampsia, acute coronary syndrome, ischemic and hemorrhagic stroke, pulmonary edema, cardiac arrhythmias, acute kidney injury, venous thromboembolism, length of stay, and cost of hospitalization. The investigators pointed out that the procedures and associated complications were identified through ICD-9 and ICD-10 codes.
Initial analysis indicated that the overall prevalence of PCOS increased over the study period, from 569 per 100,000 deliveries in 2002 to 15,349 per 100,000 deliveries in 2019. 28.2% in 2019 (P <.01 further analysis demonstrated that patients with pcos had a higher incidence of cardiovascular complications compared to their counterparts without during childbirth hospitalizations. specifically people rates preeclampsia versus per deliveries>P P P <.01>
In analyzes adjusted for age, race and ethnicity, comorbidities, insurance, and income, results indicated that people with PCOS had a higher risk of developing PCOS. preeclampsia (aOR, 1.56 [95% CI, 1.54-1.59]; P <.01 eclampsia ci>P <.01 peripartum cardiomyopathy ci>P <.01 pulmonary edema ci>P <.01 acute kidney injury ci>P <.01 and venous thromboembolism ci>P <.01 during childbirth hospitalizations than women without pcos. investigators noted that the observed increased risk of acute coronary syndrome and stroke in with pcos was not statistically significant compared to those>
Additionally, in analyzes adjusted for preeclampsia and eclampsia, results suggested that PCOS was independently associated with an increased risk of peripartum cardiomyopathy, heart failure, pulmonary edema, acute kidney injury , cardiac arrhythmia and venous thromboembolism. Further analysis of suggested predictors of negative outcomes, for women with PCOS being over 35, being black, and having diabetes, dyslipidemia, chronic hypertension, or obesity were considered as independent predictors of preeclampsia.
“Our study shows that PCOS is indeed a risk factor for acute cardiac complications at the time of childbirth and should be taken seriously,” said lead researcher Salman Zahid, MD, resident physician in the medical residency program. intern at Rochester General Hospital, in the aforementioned statement. “We want to emphasize the importance of optimizing the cardiovascular health of women with PCOS with prevention efforts, especially black women and lower socioeconomic groups, as we believe these are the most vulnerable populations and ‘they will benefit the most from the intervention.
This study, “Trends, predictors, and outcomes of cardiovascular complications associated with polycystic ovary syndrome during childbirth hospitalizations: a national analysis of hospitalized patient samples (2002-2019)was published in the Journal of the American Heart Association.