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Fecundity among wom...
Fecundity among women with polycystic ovary syndrome (PCOS)-a population-based study
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- Persson, Sofia (författare)
- Uppsala universitet,Reproduktiv hälsa,Sundsvall Cty Hosp, Dept Obstet & Gynecol, S-85186 Sundsvall, Sweden
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- Elenis, Evangelia, 1983- (författare)
- Uppsala universitet,Reproduktiv hälsa,Natl Univ Singapore, Natl Univ Hosp, Dept Obstet & Gynaecol, Singapore 119228, Singapore
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- Turkmen, Sahruh (författare)
- Umeå universitet,Obstetrik och gynekologi,Department of Obstetrics and Gynecology, Sundsvall County Hospital, Sundsvall 85186, Sweden,Umea Univ, Dept Clin Sci Obstet & Gynecol, Sundsvalls Res Unit, S-90185 Umea, Sweden;Sundsvall Cty Hosp, Dept Obstet & Gynecol, S-85186 Sundsvall, Sweden
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- Kramer, M. S. (författare)
- McGill Univ, Fac Med, Dept Epidemiol, Montreal, PQ H3G 1Y6, Canada;McGill Univ, Fac Med, Dept Biostat, Montreal, PQ H3G 1Y6, Canada;McGill Univ, Fac Med, Dept Occupat Hlth, Montreal, PQ H3G 1Y6, Canada;McGill Univ, Fac Med, Dept Pediat, Montreal, PQ H3G 1Y6, Canada;Natl Univ Singapore, Natl Univ Hosp, Dept Obstet & Gynaecol, Singapore 119228, Singapore
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Yong, E-L (författare)
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- Sundström Poromaa, Inger, 1964- (författare)
- Uppsala universitet,Reproduktiv hälsa
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(creator_code:org_t)
- 2019-09-02
- 2019
- Engelska.
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Ingår i: Human Reproduction. - : Oxford University Press. - 0268-1161 .- 1460-2350. ; 34:10, s. 2052-2060
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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Abstract
Ämnesord
Stäng
- STUDY QUESTION: Does the long-term fecundity of women with polycystic ovary syndrome (PCOS) differ from those without PCOS?SUMMARY ANSWER: Cumulative probability of childbirth is similar between women with and without PCOS.WHAT IS KNOWN ALREADY: PCOS is the main cause of anovulatory infertility in women after menarche. Previous studies indirectly suggest that fecundity in women with PCOS over the longer term may not be lower than in women without PCOS.STUDY DESIGN, SIZE, DURATION: This is a population-based study using four linked Swedish national registries. A total of 45 395 women with PCOS and 217 049 non-PCOS women were included. Follow-up began at the age of 18 years and continued for a maximum of 26 years, from 1989 to the end of 2015. Childbirth was the main outcome, as identified from the Medical Birth Register.PARTICIPANTS/MATERIALS, SETTING, METHODS: All women born between 1971 and 1997 who were identified with a PCOS diagnosis in the Swedish Patient Registry between 1 January 2001 and 31 December 2016 were included in the study population. Five controls per women with PCOS were randomly drawn from the Total Population Registry. The control women were born in the same year and living in the same municipality as the patient. The fecundity ratio (FR) was calculated by clustered Cox regression using a robust variance, adjusted for maternal birth period, country of birth and level of education.MAIN RESULTS AND THE ROLE OF CHANCE: The cumulative probability of childbirth was 80.2% (95% CI, 79.5–80.9%) in women with PCOS and 78.2% (95% CI, 77.9–78.5%) in those without PCOS. Adjusted FR was 0.81 (95% CI, 0.80–0.82) for first childbirth and 0.58 (95% CI, 0.57–0.60) for first childbirth following a spontaneous pregnancy. The FR for second childbirth was 0.79 (95% CI, 0.77–0.80). Women with PCOS had more than one child less frequently than the comparison group. Within the PCOS group, early age at diagnosis, later birth year, Nordic country of origin and low educational level positively influenced the FR.LIMITATIONS, REASONS FOR CAUTION: Results are not adjusted for BMI, and time from intention to conceive to first childbirth could not be captured. Data on pregnancies, miscarriages or abortions and fertility treatment are unknown for women who did not give birth during the study period. Women with PCOS who did not seek medical assistance might have been incorrectly classified as not having the disease. Such misclassification would lead to an underestimation of the true association between PCOS and outcomes.WIDER IMPLICATIONS OF THE FINDINGS: While cumulative probability of childbirth is similar between groups, women with PCOS need longer time to achieve their first childbirth. Women with PCOS have a lower FR and give birth to fewer children per woman than women without PCOS. Early diagnosis of and information about PCOS may improve affected women’s reproductive potential.STUDY FUNDING/COMPETING INTEREST(S): This study was funded by the Swedish Society of Medicine. Inger Sundström Poromaa has, over the past 3 years, received compensation as a consultant and lecturer for Bayer Schering Pharma, MSD, Gedeon Richter, Peptonics and Lundbeck A/S. The other authors declare no competing interests.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)
Nyckelord
- PCOS
- fecundity
- childbirth rate
- fertility
- reproduction
- fecundity ratio
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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