FRI409 Childbirth Experiences In Women With Polycystic Ovary Syndrome
Authors: Husby Anne Engtrø , Simpson Melanie Rae , Dalbye Rebecka , Vanky Eszter , Løvvik Tone Shetelig 
Published: October 2023

Disclosure: A.E. Husby: None. M.R. Simpson: None. R. Dalbye: None. E. Vanky: None. T.S. Løvvik: None.

Introduction:Polycystic ovary syndrome (PCOS) affects 5-20% of women. Women with PCOS frequently suffer from metabolic, psychological, and reproductive comorbidities. Pregnancy complications such as gestational diabetes, pregnancy-induced hypertension, pre-eclampsia, and preterm birth are more common in PCOS. Metformin has been used in an attempt to improve pregnancy outcomes in PCOS. Childbirth experience is influenced by previous life- and birth experiences, preparedness, fear of childbirth, experiences of pain and control, and the mode and outcome of delivery. A positive childbirth experience may result in improved post-partum functioning and bonding with the newborn. In contrast, a negative childbirth experience is associated with postnatal depression, post-traumatic stress symptoms and difficulties in relating to one’s partner and newborn. To our knowledge, there are no previous studies on women with PCOS and their childbirth experiences. The primary aim of our study is to explore childbirth experiences in women with PCOS compared to a reference population. The secondary aim is to explore whether metformin vs placebo during pregnancy affects the childbirth experiences in women with PCOS.

Materials and methods:This study combines data from two RCTs. In the PregMet2 study, women with PCOS in Norway, Sweden and Iceland were randomized to metformin or placebo. Main outcomes were miscarriage and preterm delivery. The Labor Progression Study (LaPS) (reference population) in Norway, compared WHO partograph to the Zhang’s guidelines for progression of labor in women in Robson group 1*. Both studies used the Childbirth Experience Questionaire (CEQ). Total CEQ scores and scores (separately) from the four domains “own capacity”, “perceived safety”, “professional support” and “participation” were compared between a) women with PCOS in the PregMet2 study (n=131) and the reference population, the LaPS study (n=3604) and b) metformin (n=179) and placebo (n=185) groups in the PregMet2 study.

Results: There was no difference in total CEQ score between women with PCOS and the reference population. Women with PCOS had a higher domain score for “perceived safety” (p&lt;0,05) and lower score for “own capacity” (p&lt;0,05), compared to the reference population, while there was no difference in the domains “professional support” or “participation”. Total CEQ-score and domain-scores were similar for the metformin compared to placebo groups in the PregMet2 study.

Conclusion: Women with PCOS compared to women in the reference population had similar childbirth experiences. However, they reported higher “perceived safety” and lower “own capacity” compared to reference women. Metformin treatment in pregnancy did not influence childbirth experience in women with PCOS.

*Nulliparous women with a singleton, term pregnancy, with spontaneous start of labor and cephalic lie (Robson group 1).

Presentation: Friday, June 16, 2023