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Medical/Surgical/Diseases/Complications

Poster Session 4

(1083) Risk of Severe Maternal Morbidity in Polycystic Ovary Syndrome

Wednesday, February 14, 2024
1:00 PM – 2:30 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective:

Patients with Polycystic Ovary Syndrome (PCOS) are more likely to have preexisting medical comorbidities and experience pregnancy related complications. We aimed to describe and compare severe maternal morbidity (SMM) rates during the delivery encounter in patients with and without a diagnosis of PCOS in a large national electronic health record database.

Study Design:

This is a retrospective cohort study of singleton deliveries from 2018-2022 using Epic’s Cosmos platform. PCOS was defined by ICD-10 codes. The primary outcome was SMM, defined by CDC’s criteria. Secondary outcomes were SMM types. We evaluated maternal age, race and ethnicity, insurance, social vulnerability index, obesity, smoking, preexisting and pregnancy related hypertension (HTN) and diabetes mellitus (DM), congenital and acquired heart disease, chronic renal disease, use of metformin, antihypertensives, and magnesium, and delivery mode. Logistic regression was used to calculate crude and adjusted odds of SMM by PCOS status.  

Results:

Of 1,817,361 deliveries, 61,485 (3.5%) patients had PCOS. Those with PCOS were more likely to be White, commercially insured, and obese; have pre-existing and pregnancy related HTN and DM; and deliver by cesarean. The SMM rate among those with PCOS was 262.7 per 10,000 (95% CI 250.3-275.6) compared to 214.8 (212.7-216.9) among non-PCOS. Unadjusted odds of SMM in patients with PCOS was 1.24 (95% CI 1.18-1.30); however, after adjusting for confounders, this was no longer statistically significant (aOR 1.01, 95% CI 0.96-1.06). Types of SMM differed between those with PCOS and those without (Table).

Conclusion:

Individuals with PCOS experience higher rates and differing types of SMM compared to those without PCOS.  The association between PCOS and SMM appears to be driven by demographic factors and medical comorbidities and not as an independent effect of PCOS. To improve pregnancy outcomes in patients with PCOS, clinicians should target modifying these risk factors.