Postpartum weight retention in women with polycystic ovary syndrome

• Published in: American journal of obstetrics and gynecology 2021-01, Vol.224 (1), p.76.e1-76.e10
• Main Authors: Lee, Iris, Alur-Gupta, Snigdha, Gallop, Robert, Dokras, Anuja
• Format: Article
• Language: English
• Subjects: Adult; Case-Control Studies; Cohort Studies; Delivery, Obstetric; Electronic Health Records; Female; Gestational Weight Gain; Humans; obesity; polycystic ovary syndrome; Polycystic Ovary Syndrome - physiopathology; postpartum weight retention; Pregnancy; Puerperal Disorders - physiopathology; Retrospective Studies; Risk Factors
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2020.07.033

Compared with women without polycystic ovary syndrome, women with polycystic ovary syndrome have a higher prevalence of cardiometabolic risk factors. Postpartum weight retention has been shown to contribute to these risks in the general population, but little is known about postpartum weight retention among women with polycystic ovary syndrome. This study aimed to compare postpartum weight retention and peripartum weight trends between women with polycystic ovary syndrome and controls. Data on live, full-term singleton deliveries from January 1, 2014, to January 1, 2019, in women with and without polycystic ovary syndrome were abstracted from the electronic medical record. Weights during the pregestational period, pregnancy, and up to 12 months postpartum were collected. The primary outcome was likelihood of high postpartum weight retention of ≥5 kg above pregestational weight at 12 months after delivery. Secondary outcomes included the prevalence of high weight retention at other postpartum time points (6 weeks, 3 months, 6 months), absolute postpartum weight retention, gestational weight gain, and excess weight gain above the Institute of Medicine guidelines for weight gain in pregnancy. A total of 6333 women had the requisite weight information (pregestational, peak pregnancy, and at least 1 postpartum weight), including 429 (6.8%) with polycystic ovary syndrome. After adjusting for age, pregestational body mass index, race, gestational diabetes mellitus, and parity, women with polycystic ovary syndrome were less likely to be high weight retainers at 6 weeks after delivery (adjusted odds ratio, 0.71; P=.02). There was no difference in postpartum weight retention between groups at 3, 6, and 12 months after delivery. Overall, the prevalence of high weight retainers at 12 months after delivery was high in both groups (22.7% in polycystic ovary syndrome vs 29.2% in controls; P=.13), and there was no difference in absolute weight retention (1.69 kg in polycystic ovary syndrome vs 2.05 kg in controls; P=.25). Although women with polycystic ovary syndrome had a higher pregestational body mass index, they had lower gestational weight gain (median, 12.7 kg) than controls (median, 13.5 kg) (P=.01). These findings were driven by the group with obesity. The percentage of women who surpassed the Institute of Medicine guidelines for gestational weight gain based on the body mass index category was similar between groups (43.4% in polycystic ovary syndrome vs 47.3% in