8558 Prevalence of Polycystic Ovary Syndrome in Adolescent Girls by World Health Organization Region
Authors: Hatoum Sana , Amiri Mina , Buyalos Richard P , Sheidaei Ali , Azziz Ricardo 
Published: October 2024

Abstract
Disclosure: S. Hatoum: None. M. Amiri: None. R.P. Buyalos: None. A. Sheidaei: None. R. Azziz: Consulting Fee; Self; Spruce Bioscience, May Health, Core Access Surgical Technologies, Acacia Bio, Fortress Biotech, Rani Therapeutics. Stock Owner; Self; Martin Imaging.
Introduction: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women of reproductive age. The use of several diagnostic criteria imposes a challenge for healthcare providers, especially in adolescents, whose PCOS symptoms may mimic normal pubertal changes. Objectives: This systematic review and meta-analysis aims to estimate the pooled prevalence of PCOS in adolescents using various diagnostic criteria in total and by WHO region. Methods: We systematically reviewed Pubmed and Embase through July 2023 to capture all studies performed in medically unbiased adolescent populations (age &lt;18 years) reporting PCOS prevalence. Studies were categorized according to: a) PCOS criteria (NIH 1990 [PCOS phenotypes A&B], AE-PCOS 2006 [PCOS phenotypes A-C], Rotterdam 2003 [PCOS phenotypes A-D], and ‘other/self-reported’ criteria); b) subject assessment type (direct assessment, survey/indirect assessment, or mixed assessment); and c) study quality, assessed using the PCOS Epidemiology and Phenotype (PEP) quality assessment tool. We performed a meta-analysis using fixed-effects or random-effects models depending on the heterogeneity among the studies. We conducted subgroup analyses based on PCOS criteria, assessment type, study quality, and WHO region. Results: 6,644 studies were initially retrieved, of which 11 were eligible for inclusion including a total of 10,516 adolescents, yielding 15 study groups according to the diagnostic criteria. Considering all studies, PCOS prevalence was 4.98% according to the NIH 1990, 8.80% according to Rotterdam 2003, 4.74% according to the AE-PCOS 2006, and 1.69% according to other criteria/self-report, with an overall pooled PCOS prevalence of 4.57%. All studies using NIH 1990, Rotterdam 2003, and AE-PCOS 2006 were of high quality, and those using other criteria/self-report were of low quality, thus subgroup analysis based on quality resulted in the same prevalences as above. When including only high-quality studies that used direct or mixed assessment, PCOS prevalence was highest in the Western Pacific Region (WPR) at 20.69% and lowest in the Eastern Mediterranean Region at 3.43% under Rotterdam 2003, while it was highest in the South-East Asia Region at 6.20% and lowest in the WPR at 3.94% under NIH 1990. Only one high-quality study using direct or mixed assessment was available under AE-PCOS 2006. Conclusion: This meta-analysis revealed that PCOS prevalence varies according to the PCOS criteria, assessment type, and WHO region. This variability should be addressed, ideally through unifying the diagnostic criteria and using meticulous methods in PCOS epidemiologic studies. The effect of study quality alone on PCOS prevalence could not be detected because of insufficient data, further reinforcing the need for undertaking PCOS prevalence studies in all populations and regions.
Presentation: 6/2/2024