Journal Article Annotations
2019, 4th Quarter

Women’s Mental Health

Annotations by Shelly Kucherer, MD
December 2019

Perinatal Mental Health in Women with Polycystic Ovary Syndrome: A Cross-Sectional Analysis of an Australian Population-Based Cohort.

PUBLICATION #1 — Women’s Mental Health

Perinatal Mental Health in Women with Polycystic Ovary Syndrome: A Cross-Sectional Analysis of an Australian Population-Based Cohort.

Tay, C. T., Teede, H. J., Boyle, J. A., Kulkarni, J., Loxton, D., & Joham, A. E.

Abstract: Journal List J Clin Med v.8(12); 2019 Dec PMC6947322

Women with polycystic ovary syndrome (PCOS) have many risk factors associated with perinatal mental disorders, but research in this area is scarce. This study aims to compare the prevalence of common perinatal mental disorders in women with and without PCOS, and examine the relationship between PCOS and common perinatal mental disorders. We performed a cross-sectional study on self-reported data of 5239 women born between 1973 to 1978 in the Australian Longitudinal Study on Women’s Health. Compared with women not reporting PCOS, women reporting PCOS had higher prevalence of antenatal depression (8.9% vs. 4.4%, p < 0.001), antenatal anxiety (11.7% vs. 5.6%, p < 0.001), postnatal depression (26.8% vs. 18.6%, p < 0.001) and postnatal anxiety (18.4% vs. 12.0%, p < 0.001). PCOS was positively associated with antenatal depression and/or anxiety (adjusted odds ratio 1.8, 95% confidence interval 1.2–2.6) but not postnatal depression and/or anxiety after controlling for sociodemographic and lifestyle factors, reproductive history, obstetric complications and pre-existing depression and anxiety. General perinatal guidelines currently do not recognize PCOS as a risk factor and the international evidence based PCOS guideline noted inadequate evidence in this area. This paper addresses the gap in literature and highlights the need to screen for common perinatal mental disorders in women with PCOS.

PMID Number:31775244

Annotation

The finding:
This cross-sectional analysis of a population-based cohort of women in Australia looked at 5239 women born between 1973 to 1978 and compared the prevalence of perinatal mental health conditions in women with and without polycystic ovary syndrome (PCOS). In the final analysis, 4803 women did not have PCOS, and 436 women had PCOS (prevalence of PCOS in this population was within the range of usual prevalence in the population). This study also examined the relationship between common perinatal mental health conditions and PCOS. In this study, 24.6% of participants had a perinatal mental disorder, which is a prevalence rate that is similar to what has been reported in other studies. Women with PCOS more commonly reported a perinatal mental health condition compared to women without PCOS (33.5% of women with PCOS compared to 23.8% without PCOS, with p<0.001). Women with PCOS had higher rates of antenatal anxiety, antenatal depression, postnatal anxiety, and postnatal depression. In addition, PCOS was associated with antenatal depression and anxiety, but not postnatal depression and anxiety after controlling for reproductive history, obstetric complications, lifestyle factors and sociodemographic factors, and pre-existing depression and anxiety.

Strength and weaknesses:
This is a large population based observational study that looks at patients with a comorbid medical condition that is not often researched within perinatal mental health. As it is a population based study, this study was done within a broadly representative sample of Australia. Many significant risk factors were looked at within this population, such as BMI, social support, obstetric complications, pre-existing psychiatric illnesses, and reproductive history. Limitations include self-reported data and binary data that does not account for situational changes over time.

Relevance:
PCOS is a common medical condition within the population and is not widely studied within perinatal mental health; however, given complications associated with this illness, it is an important illness to study and consider when seeing women in the consultation-liaison psychiatry setting. This study helps to illustrate that women with PCOS are a vulnerable population for perinatal mental health disorders and we should be screening women with PCOS for perinatal mental health conditions.

Type of study:
(http://ebm.bmj.com/content/early/2016/06/23/ebmed-2016-110401): Cross-Sectional analysis of a population-based cohort