Polycystic ovary syndrome and postpartum depression symptoms: a population-based cohort study

Koric, Alzina; Singh, Bhavneet; VanDerslice, James; Stanford, Joseph B.; Rogers, Charles R.; Egan, D; Agyemang, Daniel Opoku; Schliep, Karen C.

doi:10.1016/j.ajog.2020.12.1215

Cited by 20 publications

(14 citation statements)

References 17 publications

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“…Most patients with PCOS present with infertility due to ovulation dysfunction [2] . After treatment with menstrual cycle adjustment, ovulation induction, and assisted reproductive technology, most patients can become pregnant, but due to the influence of underlying diseases, although the pregnancy can be successful, the adverse pregnancy outcome and the incidence of complications during pregnancy is relatively high [3,4] . Studies [5,6] have shown that the incidence of diabetes in PCOS women between 20 and 40 years old is as high as 20% to 40%.…”

Section: Introductionmentioning

confidence: 99%

The risk factors of gestational diabetes mellitus in patients with polycystic ovary syndrome

Liu

Zuo

et al. 2021

Medicine

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The influencing factors of gestational diabetes mellitus (GDM) in the polycystic ovary syndrome (PCOS) patients remain unclear, we aimed to investigate the risk factors of GDM in patients with PCOS, to provide reliable evidence for the prevention and treatment of GDM in PCOS patients.PCOS patients treated in our hospital from January 1, 2019 to October 31, 2020 were included. The personal and clinical treatment details of GDM and no GDM patients were analyzed. Logistic regressions were performed to analyze the factors influencing the occurrence of GDM.A total of 196 PCOS patients were included, the incidence of GDM in patients with PCOS was 23.98%. There were significant differences in the age, body mass index, insulin resistance index, fasting insulin, testosterone, androstenedione, and sex hormonebinding protein between GDM and no GDM patients with PCOS (all P < .05), and no significant differences in the family history of GDM, the history of adverse pregnancy, and multiple pregnancies were found (all P > .05). Age ≥30 years (odds ratio (OR) 2.418, 95% confidence interval (CI) 1.181-3.784), body mass index ≥24 kg/m 2 (OR 1.973, 95%CI 1.266-3.121), insulin resistance index ≥22.69 (OR 2.491,, fasting insulin ≥22.71 mIU/L (OR 2.508, 95%CI 1.166-5.057), testosterone ≥2.85 nmol/L (OR 1.821, 95%CI 1.104-2.762), androstenedione ≥6.63 nmol/L (OR 1.954, 95%CI 1.262-2.844), sex hormone-binding protein <64.22 nmol/L (OR 1.497, 95%CI 1.028-2.016) were the independent risk factors of GDM in patients with PCOS (all P < .05). The incidence of preeclampsia, premature delivery, premature rupture of membranes, polyhydramnios, and postpartum hemorrhage in the GDM group was significantly higher than that of the no-GDM group (all P < .05). There was no significant difference in the incidence of oligohydramnios between the 2 groups (P = .057).

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Section: Introductionmentioning

confidence: 99%

The risk factors of gestational diabetes mellitus in patients with polycystic ovary syndrome

Liu

Zuo

et al. 2021

Medicine

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“…Six studies, all of high quality (Supplemental Table 6), were included examining the association between postpartum depression and PCOS (30)(31)(32)(33)(34)(35)(36). Compared to age-matched women without PCOS, those with PCOS had a higher prevalence of postpartum depression in the meta-analysis, however this association did not reach statistical significance (random effects PR: 1.20; 95% CI: 0.96, 1.50; Fig.…”

Section: Excess Prevalence Of Postpartum Depression In Women With Pcosmentioning

confidence: 99%

Direct Economic Burden of Mental Health Disorders Associated with Polycystic Ovary Syndrome: Systematic Review and Meta-analysis

Yadav

Delau

Bonner

et al. 2023

Preprint

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BACKGROUND: Polycystic ovary syndrome (PCOS) is the most common hormone disorder affecting about one in seven reproductive-aged women worldwide and approximately 6 million women in the United States (U.S.). PCOS can be a significant burden to those affected and is associated with an increased prevalence of mental health (MH) disorders such as depression, anxiety, eating disorders, and postpartum depression. We undertook this study to determine the excess economic burden associated with MH disorders in women with PCOS, in order to allow for a more accurate prioritization of the disorder as a public health priority. <br />METHODS: Followed PRISMA reporting guidelines for systematic review, we searched 60 PubMed, Web of Science, EBSCO, Medline, Scopus, and PsycINFO through July 16, 2021, for studies on MH disorders in PCOS. Excluded were studies not in humans, without controls, without original data, or not peer reviewed. As anxiety, depression, eating disorders, and postpartum depression were by far the most common MH disorders assessed by the studies, we performed our meta-analysis on these disorders. Meta-analyses were performed using the DerSimonian-Laird random-effects model to compute pooled estimates of prevalence ratios (PR) for the associations between PCOS and these MH disorders, and then calculated the excess direct costs of related to these disorders in U.S. dollars (USD) for women suffering from PCOS in the U.S. alone. The quality of selected studies was assessed using the Newcastle Ottawa Scale. <br />RESULTS: We screened 78 articles by title/abstract, assessed 43 articles in full-text, and included 25 articles. Pooled PRs were 1.42 (95% CI: 1.32-1.52) for anxiety, 1.65 (95% CI: 1.44- 1.89;) for depression, 1.48 (95% CI: PR: 1.06-2.05) for eating disorders, and 1.20 (95% CI: 0.96-1.50) for postpartum depression, for PCOS relative to controls. In the U.S, the additional direct healthcare costs associated with anxiety, depression and eating disorders in PCOS were estimated to be $1.939 billion/yr., 1.678 billion/yr., and $0.644 billion/yr. in 2021 USD, respectively. Postpartum depression was excluded from the cost analyses due to the non-significant meta-analysis result. Taken together, the additional direct healthcare costs associated with anxiety, depression and eating disorders in PCOS was estimated to be $4.261 billion/yr. in 2021 USD. <br />CONCLUSIONS: Overall, the direct healthcare annual costs for the most common MH disorders in PCOS, namely anxiety, depression, and eating disorders exceeds $4 billion in 2021 USD for the U.S. population alone. Taken together with our prior work, these data suggest that the healthcare-related economic burden of PCOS exceeds $15 billion yearly, considering the costs of PCOS diagnosis, and cost related to PCOS-associated MH, reproductive, vascular, and metabolic disorders. As PCOS has much the same prevalence across the world, the excess economic burden attributable to PCOS globally is enormous, mandating that the scientific and policy community increase its focus on this important disorder. <br />FUNDING: The study was supported, in part, by PCOS Challenge: The National Polycystic Ovary Syndrome Association and by the Foundation for Research and Education Excellence

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“…Women with GDM and hypertensive disorders of pregnancy are more likely to experience anxiety and depression 54 . Two recent studies on unselected populations of women with and without PCOS found that women with PCOS have a higher risk for antenatal depression and anxiety 55,56 . The association of antenatal psychological complications with PCOS remained significant for women who had oligoanovulation and acne 56 and also for those who had a history of stillbirth but not for post‐ART pregnancies 55 …”

Section: Pcos Pregnancy and Birth Complicationsmentioning

confidence: 99%

Clinical management of pregnancy in women with polycystic ovary syndrome: An expert opinion

Khomami

Teede

Joham

et al. 2022

Clinical Endocrinology

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Polycystic ovary syndrome (PCOS) is associated with a higher risk for pregnancy and birth complications according to the specific features associated with PCOS.The features include obesity before and during pregnancy, hyperandrogenism, insulin resistance, infertility, cardiometabolic risk factors, and poor mental health.PCOS is not often recognized as a risk factor for poor pregnancy and birth outcomes in pregnancy care guidelines, while its associated features are. Pregnancy-related risk profile should ideally be assessed for modifiable risk factors (e.g., lifestyle and weight management) at preconception in women with PCOS. Hyperglycaemia should be screened using a 75-g oral glucose tolerance test at preconception or within the first 20 weeks of pregnancy if it has not been performed at preconception and should be repeated at 24-28 weeks of pregnancy. In the absence of evidence of benefit for strategies specific to women with PCOS, the international evidencebased guidelines for the assessment and management of PCOS recommend screening, optimizing, and monitoring risk profile in women with PCOS (at preconception, during and postpregnancy) consistent with the recommendations for the general population. Recommended factors include blood glucose, weight, blood pressure, smoking, alcohol, diet, exercise, sleep and mental health, emotional, and sexual health among women with PCOS. The guidelines recommend Metformin in addition to lifestyle for assisting with weight management and improving cardiometabolic risk factors, particularly in those with overweight or obesity.

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Polycystic ovary syndrome and postpartum depression symptoms: a population-based cohort study

Cited by 20 publications

References 17 publications

The risk factors of gestational diabetes mellitus in patients with polycystic ovary syndrome

The risk factors of gestational diabetes mellitus in patients with polycystic ovary syndrome

Direct Economic Burden of Mental Health Disorders Associated with Polycystic Ovary Syndrome: Systematic Review and Meta-analysis

Clinical management of pregnancy in women with polycystic ovary syndrome: An expert opinion

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