A common hormone disorder among women of reproductive age has been linked to an increased risk of adverse cardiovascular events and pregnancy outcomes at the time of birth, according to a new study led by Johns Hopkins Medicine researchers.

The study was published June 16 in the Journal of the American Heart Association.

Polycystic ovary syndrome (PCOS) affects an estimated 5%-13% of women in the general population. It causes irregular periods, excess levels of male hormones (androgens) and, at times, infertility. Building on previous research that shows PCOS is linked to future cardiovascular disease risks later in life, the new findings reveal that it can also significantly increase heart problems among pregnant women during delivery. These problems include preeclampsia (dangerous levels of high blood pressure with organ damage), peripartum cardiomyopathy (a weak or enlarged heart), heart failure, abnormal heart rhythms and venous thromboembolism (blood clots), compared with women without PCOS.

“Oftentimes, women with PCOS are understandably concerned about the immediate effects, like an irregular menstrual cycle, excess body hair, weight gain and acne. However, the long-term cardiovascular complications are also a serious problem,” said Erin Michos, M.D., associate professor of medicine at the Johns Hopkins University School of Medicine and corresponding author of the study. Michos said the new study should encourage women with PCOS to live a heart-healthy lifestyle before, during and after pregnancy to reduce the risk of adverse outcomes.

For the study, researchers analyzed data gathered on more than 17 million U.S. births between 2002 and 2019 drawn from the National Inpatient Sample. Among those with hospitalized deliveries, 195,675 had PCOS. The prevalence of PCOS — and obesity among those with the hormone disorder — increased significantly during the study period. The number of women with PCOS went from a reported 569 per 100,000 deliveries in 2002 to 15,349 per 100,000 deliveries in 2019. During that same time period, obesity also skyrocketed from 5.7% to 28.2% among women with PCOS. Michos and colleagues note that some of the increase in PCOS may be due to better detection and diagnosis.

After adjusting for age, race, other disorders not related to PCOS, insurance coverage and income, PCOS remained an independent predictor of heart complications during delivery compared with women who did not have the hormone disorder. Complications included preeclampsia, with a 56% increased comparative risk; heart failure, with a 76% increased risk; abnormal heart rhythms, with a two-fold higher risk; weakened heart, with a 79% higher risk; and an 82% higher risk of developing blood clots.

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