Trends, Predictors, and Outcomes of Cardiovascular Complications Associated With Polycystic Ovary Syndrome During Delivery Hospitalizations: A National Inpatient Sample Analysis (2002-2019)
Department
Cardiology
Document Type
Article
Publication Title
Journal of the American Heart Association
Abstract
Background: Women with polycystic ovary syndrome (PCOS) have an increased risk of pregnancy‐associated complications. However, data on peripartum cardiovascular complications remain limited. Hence, we investigated trends, outcomes, and predictors of cardiovascular complications associated with PCOS diagnosis during delivery hospitalizations in the United States.
Methods and Results: We used data from the National Inpatient Sample (2002–2019). International Classification of Diseases, Ninth Revision (ICD‐9), or International Classification of Diseases, Tenth Revision (ICD‐10), codes were used to identify delivery hospitalizations and PCOS diagnosis. A total of 71 436 308 weighted hospitalizations for deliveries were identified, of which 0.3% were among women with PCOS (n=195 675). The prevalence of PCOS, and obesity among those with PCOS, increased during the study period. Women with PCOS were older (median, 31 versus 28 years; P< 0.01) and had a higher prevalence of diabetes, obesity, and dyslipidemia. After adjustment for age, race and ethnicity, comorbidities, insurance, and income, PCOS remained an independent predictor of cardiovascular complications, including preeclampsia (adjusted odds ratio [OR], 1.56 [95% CI, 1.54–1.59]; P< 0.01), eclampsia (adjusted OR, 1.58 [95% CI, 1.54–1.59]; P< 0.01), peripartum cardiomyopathy (adjusted OR, 1.79 [95% CI, 1.49–2.13]; P< 0.01), and heart failure (adjusted OR, 1.76 [95% CI, 1.27–2.45]; P< 0.01), compared with no PCOS. Moreover, delivery hospitalizations among women with PCOS were associated with increased length (3 versus 2 days; P< 0.01) and cost of hospitalization ($4901 versus $3616; P< 0.01).
Conclusions: Women with PCOS had a higher risk of preeclampsia/eclampsia, peripartum cardiomyopathy, and heart failure during delivery hospitalizations. Moreover, delivery hospitalizations among women with PCOS diagnosis were associated with increased length and cost of hospitalization. This signifies the importance of prepregnancy consultation and optimization for cardiometabolic health to improve maternal and neonatal outcomes.
First Page
e025839
DOI
10.1161/JAHA.121.025839
Volume
11
Issue
16
Publication Date
8-16-2022
PubMed ID
35708290
Recommended Citation
Zahid, S., Khan, M. Z., Gowda, S., Faza, N. N., Honigberg, M. C., Vaught, A. J., Guan, C., Minhas, A. S., & Michos, E. D. (2022). Trends, Predictors, and Outcomes of Cardiovascular Complications Associated With Polycystic Ovary Syndrome During Delivery Hospitalizations: A National Inpatient Sample Analysis (2002-2019). Journal of the American Heart Association, 11 (16), e025839. https://doi.org/10.1161/JAHA.121.025839