Comprehensive Analysis of Psychological, Social and Clinical Aspects of Polycystic Ovary Syndrome in Pregnancy: Insights From the Born in Bradford Cohort Study.
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INTRODUCTION: Polycystic ovary syndrome (PCOS) presents complex challenges during pregnancy, affecting both maternal and neonatal health. This study aims to provide a comprehensive analysis of the demographic, social and clinical dimensions of PCOS in pregnancy, utilising data from the Born in Bradford (BiB) cohort. METHODS: A retrospective cohort study used data from the BiB cohort, including pregnant women with PCOS and a control group. Demographic, social, and clinical characteristics were analysed, with data collected from electronic health records, maternal questionnaires, and medical records. The General Health Questionnaire-28 (GHQ-28) assessed overall well-being and psychological distress. Statistical analysis included descriptive statistics, Fischer's exact tests, independent t-tests, Mann-Whitney U tests, and logistic regression analysis. RESULTS: The study included 279 pregnant women diagnosed with PCOS and 10,284 controls. After adjusting for age, women with PCOS had significantly higher GHQ-28 scores than controls (β = 2.65, SD = 0.86, p = 0.002). PCOS was associated with significantly increased odds of pre-eclampsia (OR: 2.09, 95% CI: 1.18-3.71, p = 0.01) and gestational hypertension (OR: 1.69, 95% CI: 1.19-2.38, p = 0.005). However, after adjusting for BMI, the association between PCOS and pre-eclampsia was no longer significant, though mediation analysis confirmed that BMI played a significant mediating role. Infants born to mothers with PCOS had significantly higher odds of stillbirth (OR: 4.93, 95% CI: 1.92-12.62, p = 0.005) and lower overall birth weights. A gender-stratified analysis showed that the reduction in birth weight was particularly pronounced in female infants (3164.5 ± 535.7 g vs. 3011.2 ± 581.0 g; p = 0.004), whereas no significant difference was observed in male infants (p > 0.05). CONCLUSION: The findings underscore the importance of considering demographic, social, and clinical factors in the management of pregnant women with PCOS.