Hochberg Alyssa, Badeghiesh Ahmad, Baghlaf Haitham, Tseva Ayellet Tzur, Dahan Michael H
Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada.
The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Int J Gynaecol Obstet. 2024 Apr;165(1):275-281. doi: 10.1002/ijgo.15201. Epub 2023 Oct 19.
To evaluate the modifying effect of low socioeconomic status (SES) on polycystic ovary syndrome (PCOS) women's pregnancy and neonatal complications.
A retrospective population-based cohort study including all women with an ICD-9 diagnosis of PCOS in the US between 2004 and 2014, who delivered in the third trimester or had a maternal death. SES was defined according to the total annual family income quartile for the entire population studied. We compared women in the lowest income quartile (<$39 000 annually) to those in the higher income quartiles combined (≥$39 000 annually). Pregnancy, delivery, and neonatal outcomes were compared between the two groups.
Overall, 9 096 788 women delivered between 2004 and 2014, of which 12 322 had a PCOS diagnosis and evidence of SES classification. Of these, 2117 (17.2%) were in the lowest SES group, and 10 205 (82.8%) were in the higher SES group. PCOS patients in the lowest SES group, compared to the higher SES group, were more likely to be younger, obese (body mass index ≥30 kg/m ), to have smoked tobacco during pregnancy, and to have chronic hypertension and pregestational diabetes mellitus (DM) (P < 0.05). In a multivariate logistic regression, women in the lowest SES group, compared to the higher SES group, had increased odds of pregnancy-induced hypertension (aOR 1.27, 95% CI: 1.12-1.46, P < 0.001), pre-eclampsia (aOR 1.37, 95% CI: 1.14-1.65, P < 0.001), and cesarean delivery (aOR 1.21, 95% CI: 1.09-1.34, P < 0.001), with other comparable pregnancy, delivery and neonatal outcomes.
In PCOS patients, low SES increases the risk for pregnancy-induced hypertension, pre-eclampsia and CD, highlighting the importance of diligent pregnancy follow-up and pre-eclampsia prevention in these patients.
评估低社会经济地位（SES）对多囊卵巢综合征（PCOS）女性妊娠及新生儿并发症的影响。
一项基于人群的回顾性队列研究，纳入2004年至2014年间在美国诊断为PCOS且在孕晚期分娩或发生孕产妇死亡的所有女性。SES根据所研究总体人群的家庭年收入四分位数来定义。我们将收入最低四分位数组（每年<$39000）的女性与较高收入四分位数组合并组（每年≥$39000）的女性进行比较。比较两组之间的妊娠、分娩及新生儿结局。
总体而言，2004年至2014年间有9096788名女性分娩，其中12322名有PCOS诊断且有SES分类证据。其中，2117名（17.2%）属于最低SES组，10205名（82.8%）属于较高SES组。与较高SES组相比，最低SES组的PCOS患者更年轻、肥胖（体重指数≥30kg/m²），孕期吸烟，且患有慢性高血压和孕前糖尿病（DM）（P<0.05）。在多因素逻辑回归分析中，与较高SES组相比，最低SES组的女性发生妊娠高血压（调整后比值比[aOR]1.27，95%置信区间[CI]：1.12 - 1.46，P<0.001）、子痫前期（aOR 1.37，95% CI：1.14 - 1.65，P<0.001）和剖宫产（aOR 1.21，95% CI：1.09 - 1.34，P<0.001）的几率增加，其他妊娠、分娩及新生儿结局具有可比性。
在PCOS患者中，低SES增加了妊娠高血压、子痫前期和剖宫产的风险，凸显了对这些患者进行认真的孕期随访和预防子痫前期的重要性。
