TY - JOUR
T1 - Trends, Predictors, and Outcomes of Cardiovascular Complications Associated With Polycystic Ovary Syndrome During Delivery Hospitalizations
T2 - A National Inpatient Sample Analysis (2002–2019)
AU - Zahid, Salman
AU - Khan, Muhammad Zia
AU - Gowda, Smitha
AU - Faza, Nadeen N.
AU - Honigberg, Michael C.
AU - Vaught, Arthur
AU - Guan, Carolyn
AU - Minhas, Anum S.
AU - Michos, Erin D.
N1 - Funding Information:
Dr Michos is supported by the Amato Fund for Women’s Cardiovascular Health research at Johns Hopkins University. Dr Honigberg received grant support from the American Heart Association (940166).
Publisher Copyright:
© 2022 The Authors.
PY - 2022/8/16
Y1 - 2022/8/16
N2 - BACKGROUND: Women with polycystic ovary syndrome (PCOS) have an increased risk of pregnancy-associated complica-tions. 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.
AB - BACKGROUND: Women with polycystic ovary syndrome (PCOS) have an increased risk of pregnancy-associated complica-tions. 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.
KW - cardiovascular disease
KW - eclampsia
KW - polycystic ovary syndrome
KW - preeclampsia
KW - Pre-Eclampsia/epidemiology
KW - Cardiomyopathies/complications
KW - Humans
KW - Heart Failure/complications
KW - Hospitalization
KW - Pregnancy
KW - Inpatients
KW - United States/epidemiology
KW - Eclampsia
KW - Obesity/complications
KW - Female
KW - Polycystic Ovary Syndrome/complications
KW - Infant, Newborn
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U2 - 10.1161/JAHA.121.025839
DO - 10.1161/JAHA.121.025839
M3 - Article
C2 - 35708290
AN - SCOPUS:85136118834
SN - 2047-9980
VL - 11
SP - e025839
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 16
M1 - e025839
ER -