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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). (), or (), 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; <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]; <0.01), eclampsia (adjusted OR, 1.58 [95% CI, 1.54-1.59]; <0.01), peripartum cardiomyopathy (adjusted OR, 1.79 [95% CI, 1.49-2.13]; <0.01), and heart failure (adjusted OR, 1.76 [95% CI, 1.27-2.45]; <0.01), compared with no PCOS. Moreover, delivery hospitalizations among women with PCOS were associated with increased length (3 versus 2 days; <0.01) and cost of hospitalization ($4901 versus $3616; <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.

背景

多囊卵巢综合征（PCOS）女性妊娠相关并发症风险增加。然而，围产期心血管并发症的数据仍然有限。因此，我们研究了美国分娩住院期间与 PCOS 诊断相关的心血管并发症的趋势、结局和预测因素。

方法和结果

我们使用了国家住院患者样本（2002-2019 年）的数据。使用产科（产科）和（妇科）代码来识别分娩住院和 PCOS 诊断。共确定了 71436308 例分娩加权住院，其中 0.3%为 PCOS 女性（n=195675）。在研究期间，PCOS 的患病率和肥胖症在 PCOS 患者中增加。PCOS 女性年龄较大（中位数 31 岁与 28 岁；<0.01），且糖尿病、肥胖症和血脂异常的患病率较高。在校正年龄、种族和民族、合并症、保险和收入后，PCOS 仍然是心血管并发症的独立预测因素，包括子痫前期（校正比值比 [OR]，1.56 [95%CI，1.54-1.59]；<0.01）、子痫（校正 OR，1.58 [95%CI，1.54-1.59]；<0.01）、围产期心肌病（校正 OR，1.79 [95%CI，1.49-2.13]；<0.01）和心力衰竭（校正 OR，1.76 [95%CI，1.27-2.45]；<0.01）。此外，与没有 PCOS 的女性相比，PCOS 女性的分娩住院时间更长（3 天与 2 天；<0.01），住院费用更高（4901 美元与 3616 美元；<0.01）。