Lack of Adequate Counseling about Pregnancy Complications in Patients with Polycystic Ovary Syndrome: A Cross-Sectional Survey Study

ObjectiveTo assess the counseling experiences of patients with polycystic ovary syndrome (PCOS) related to obstetric complications and preconception management of comorbidities.DesignCross-sectional survey study.SubjectsPCOS patients with history of or attempt at pregnancy.Main outcome measuresDemographic characteristics, medical history, counseling experiences.ResultsOf the 302 respondents, 72.9% had a prior pregnancy with 66.8% reporting complications during pregnancy. 52.7% of the entire cohort received preconception counseling on PCOS-related obstetric complications and 41.5% were satisfied with their counseling experience. 5.0% were counseled on related postpartum complications. 43.4% received counseling about pre-pregnancy weight management, with the minority satisfied with their counseling. Among those with existing comorbidities including hypertension, diabetes, and anxiety or depression, the minority of respondents received counseling on their preconception management. Although there were no racial disparities in overall counseling of pregnancy complications, more Black patients were counseled about preeclampsia (p=0.009), cesarean section (p=0.03), and preterm birth (p=0.005) compared to White patients. Among patients who had a single provider managing their PCOS care, 78.6% who saw a reproductive endocrinologist, 53.2% who saw a general gynecologist, and 35.0% who saw a primary care physician reported receiving counseling on related pregnancy complications.ConclusionsDespite the high prevalence of obstetric complications associated with PCOS, our study revealed inadequate patient counseling about both the antepartum and postpartum periods and the preconception management of existing comorbidities. Our findings highlight the urgent need to increase provider education and patient awareness in order to optimize maternal and neonatal outcomes.