ABSTRACT
PURPOSE: To determine whether the prevalence in American demographic and resultant adverse obstetric outcomes changed in women with polycystic ovary syndrome between the years of 2004-2014 inclusively, based on data derived from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (HCUP-NIS) database. METHODS: This is a retrospective population-based study using data derived from the HCUP-NIS database from the years of 2004-2014, inclusively. Within this group, all pregnancies to women with PCOS were identified and separated by year, creating 11 groups. RESULTS: Risk factors including non-Caucasian race, lower socioeconomic status, and rates of obesity and thyroid disease increased over time. The rates of gestational diabetes mellitus demonstrated a slight decrease, (21.3% in 2004 to 18.0% in 2014, P = 0.01). The number of women with preterm premature rupture of membranes decreased from 3.0% in 2004 to 2.0% in 2014 (P = 0.04). Rates of preterm delivery decreased from 14.8% in 2004 to 9.8% in 2014 (P < 0.001). Rates of cesarean section decreased from 57.3% in 2004 to 45.7% in 2014 (P < 0.001), while rates of spontaneous vaginal delivery increased from 37.4% in 2004 to 50.1% in 2014 (P < 0.001). The rate of wound complications decreased from 2.1% in 2004 to 0.4% in 2014 (P < 0.001). However, the rate of congenital anomalies increased from 0.5% in 2004 to 1.2% in 2014 (P = 0.001). CONCLUSIONS: In spite of increases in demographic risk factors associated with increased pregnancy complications, we hypothesize that the interventions made to minimize the risks of cesarean section and manage metabolic complications in women with PCOS during the period of study have resulted in improved pregnancy outcomes during the period of study.
ABSTRACT
OBJECTIVE: The purpose of this study was to determine the prevalence of kyphosis in a Turner syndrome (TS) population. METHODS: Standing lateral thoracic spine and standing anterior-posterior (A-P) scoliosis radiographs were obtained on all girls with TS between the ages of 5 and 18 years seen in a TS clinic between July 2000 and March 2001. Medical histories were reviewed, and a pediatric orthopedic surgeon evaluated the radiographs of each patient (N = 25). Excessive kyphosis was defined as an A-P curvature >40 degrees, vertebral wedging as any A-P deformity >5 degrees at an individual vertebral body, and scoliosis as a lateral curvature >10 degrees. RESULTS: Fifteen (60%) of 25 patients were found to have abnormal radiographic findings: 10 (40%) of 25 with excessive kyphosis, 10 (40%) of 25 with vertebral wedging, and 5 (20%) of 25 with scoliosis. Forty-eight percent of the girls had both excessive kyphosis and/or vertebral body wedging. Two girls had kyphosis > or =55 degrees, and 5 had scoliosis > or =25 degrees. Girls with excessive kyphosis and/or vertebral body wedging were older (13.6 +/- 3.9 years vs 10.6 +/- 2.8 years). CONCLUSIONS: The prevalence of excessive kyphosis and vertebral body wedging seems to be increased in girls with TS and corresponds with advancing age. Routine radiologic surveillance may facilitate detection of developing deformities so that treatment with a brace can be considered to prevent or slow the process.
