Published date: Sep 03 2019

Journal Title: International Journal of Reproductive BioMedicine

Issue title: International Journal of Reproductive BioMedicine (IJRM): Volume 17, Issue No. 8

Pages: 533–542

DOI: 10.18502/ijrm.v17i8.4818

Marzieh Saei Ghare NazStudent Research Committee, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Fahimeh Ramezani TehraniReproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Hamid Alavi MajdDepartment of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Fazlollah AhmadiDepartment of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran

Giti Ozgoligozgoli@gmail.comDepartment of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Farzaneh Rashidi FakariStudent Research Committee, Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Vida GhasemiStudent Research Committee, Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Background: Polycystic ovarian syndrome is an endocrine disorder with many complications. This syndrome is a growing concern among adolescents around the world, with varying reports of its prevalence in different parts of the world.

Objective: This study aimed to determine the prevalence of polycystic ovary syndrome in adolescents by a systematic review and meta-analysis.

Materials and Methods: In this study, a search for published articles with an English language limitation and without a time limit was done in different databases (Scopus, PubMed, and Web of Science, Emabse and Cochrane) in January 2019. The 12 studies that met the criteria for entering a qualitative assessment scale of 5 and higher were subjected to systematic review and meta-analysis. Egger and Begg’s tests were used to check the publication bias. Data were analyzed with STATA software, version 11.1.

Results: Twelve studies were included for meta-analysis. The total number of participants in the study was 149,477. The average quality score of all studies was 8.67 (range: 5–10). The prevalence of polycystic ovarian syndrome in adolescents based on the Rotterdam criteria was 11.04% (95% CI: 6.84–16.09%), based on the National Institute of Health criteria, it was 3.39% (95% CI: 0.28–9.54%), and based on Androgen Excess and Polycystic Ovary Syndrome Society, it was 8.03% (95% CI: 6.24–10.01%).

Conclusion: The result of this study showed that there is a variation in the prevalence of PCOS in adolescents based on different criteria; we suggest more community-based studies among adolescences in different parts of the world.

[1] Pasquali R. Contemporary approaches to the management of polycystic ovary syndrome. Ther Adv Endocrinol Metab 2018; 9: 123–134.

[2] Farooq R. Short Review on Polycystic Ovarian Syndrome. Journal of Medicine 2018; 19: 49–53.

[3] Ding T, Hardiman PJ, Petersen I, Wang FF, Qu F, Baio G. The prevalence of polycystic ovary syndrome in reproductive-aged women of different ethnicity: a systematic review and meta-analysis. Oncotarget 2017; 8: 96351–96358.

[4] Sirmans SM, Pate KA. Epidemiology, diagnosis, and management of polycystic ovary syndrome. Clin Epidemiol 2013; 6: 1–13.

[5] Diamanti-Kandarakis E. PCOS in adolescents. Best Pract Res Clin Obstet Gynaecol 2009; 24: 173–183.

[6] El Hayek S, Bitar L, Hamdar LH, Mirza FG, Daoud G. Poly cystic ovarian syndrome: an updated overview. Front Physiol 2016; 7: 124.

[7] Hart R, Doherty DA. The potential implications of a PCOS diagnosis on a woman’s long-term health using data linkage. J Clin Endocrinol Metab 2015; 100: 911–919.

[8] Bazarganipour F, Taghavi SA, Montazeri A, Ahmadi F, Chaman R, Khosravi A. The impact of polycystic ovary syndrome on the health-related quality of life: A systematic review and meta-analysis. Iran J Reprod Med 2015; 13: 61–70.

[9] Franks S. Polycystic ovary syndrome in adolescents. Int J Obes 2008; 32: 1035–1041.

[10] Rosenfield RL. Clinical review: Identifying children at risk for polycystic ovary syndrome. J Clin Endocrinol Metab 2007; 92: 787–796.

[11] Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 2004; 41–47.

[12] Carmina E. Diagnosis of polycystic ovary syndrome: from NIH criteria to ESHRE-ASRM guidelines. Minerva Ginecol 2004; 56: 1–6.

[13] Azziz R, Carmina E, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W et al. Positions statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an androgen excess society guideline. J Clin Endocrinol Metab 2006; 91: 4237–4245.

[14] Pfeifer SM, Kives S. Polycystic ovary syndrome in the adolescent. Obstet Gynecol Clin Noth Am 2009; 36: 129–152.

[15] Driscoll DA. Polycystic ovary syndrome in adolescence. Ann N Y Acad Sci 2003; 997: 49–55.

[16] Witchel SF, Oberfield S, Rosenfield RL, Codner E, Bonny A, Iba´ n˜ez L et al. The diagnosis of polycystic ovary syndrome during adolescence. Horm Res Paediatr 2015; 83: 376–389.

[17] Williams RM, Ong KK, Dunger DB. Polycystic ovarian syndrome during puberty and adolescence. Mol Cell Endocrinol 2013; 373: 61–67.

[18] Merino PM, Codner E, Cassorla F. A rational approach to the diagnosis of polycystic ovarian syndrome during adolescence. Arq Bras Endocrinol Metabol 2011; 55: 590–598.

[19] Kamboj MK, Bonny AE. Polycystic ovary syndrome in adolescence: diagnostic and therapeutic strategies. Transl Pediatr 2017; 6: 248–255.

[20] March WA, Moore VM, Willson KJ, Phillips DI, Norman RJ, Davies MJ. The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria. Hum Reprod 2010; 25: 544–551.

[21] Shannon M,Wang Y. Polycystic ovary syndrome: a common but often unrecognized condition. J Midwifery Womens Health 2012; 57: 221–230.

[22] Joshi B, Mukherjee S, Patil A, Purandare A, Chauhan S, Vaidya R. A cross-sectional study of polycystic ovarian syndrome among adolescent and young girls in Mumbai, India. Indian J Endocrinol Metab 2014; 18: 317–324.

[23] Kaewnin J, Vallibhakara O, Arj-Ong Vallibhakara S, Wattanakrai P, Butsripoom B, Somsook E et al. Prevalence of polycystic ovary syndrome in Thai University adolescents. Gynecol Endocrinol 2018; 34: 476–480.

[24] Asgharnia M, Mirblook F, Soltani M. The prevalence of polycystic ovary syndrome (PCOS) in high school students in Rasht in 2009 according to NIH criteria. Int J Fertil Steril 2011; 4: 156–159.

[25] Esmaeilzadeh S, Delavar MA, Amiri M, Khafri S, Pasha NG. Polycystic ovary syndrome in Iranian adolescents. Int J Adolesc Med Health 2014; 26: 559–565.

[26] Munn Z, Moola S, Riitano D, Lisy K. The development of a critical appraisal tool for use in systematic reviews addressing questions of prevalence. Int J Health Policy Manag 2014; 3: 123–128.

[27] Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997; 315: 629–634.

[28] Freeman MF, Tukey JW. Transformations related to the angular and the square root. The Annals of Mathematical Statistics 1950; 21: 607–611.

[29] Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Reviews 2015; 1–9.

[30] Nidhi R, Padmalatha V, Nagarathna R, Amritanshu R. Prevalence of polycystic ovarian syndrome in Indian adolescents. J Pediatr Adolesc Gynecol 2011; 24: 223–227.

[31] Akbarzadeh M, Naderi T, Dabbagh Manesh MH, Tabatabaee HR. The frequency of various phenotypes of polycystic ovarian syndrome in adolescents, based on rotterdam criteria. Int J School Health 2015; 2: e26512.

[32] Sharif E, Rahman S, Zia Y, Rizk NM. The frequency of polycystic ovary syndrome in young reproductive females in Qatar. Int J Womens Health 2016; 9: 1–10.

[33] Mehrabian F, Khani B, Kelishadi R, Ghanbari E. The prevalence of polycystic ovary syndrome in Iranian women based on different diagnostic criteria. Endokrynol Pol 2011; 62: 238–242.

[34] Tehrani FR, Simbar M, Tohidi M, Hosseinpanah F, Azizi F. The prevalence of polycystic ovary syndrome in a community sample of Iranian population: Iranian PCOS prevalence study. Reprod Biol Endocrinol 2011; 9: 39.

[35] Ybarra M, Franco RR, Cominato L, Sampaio RB, Sucena da Rocha SM, Damiani D. Polycystic Ovary syndrome among obese adolescents. J Gynecol Endocrinol 2018; 34: 45–48.

[36] Jalilian A, Kiani F, Sayehmiri F, Sayehmiri K, Khodaee Z, Akbari M. Prevalence of polycystic ovary syndrome and its associated complications in Iranian women: A meta-analysis. Iran J Reprod Med 2015; 13: 591–604.

[37] Bozdag G, Mumusoglu S, Zengin D, Karabulut E, Yildiz BO. The prevalence and phenotypic features of polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod 2016; 31: 2841–2855.

[38] Rashidi H, Ramezani Tehrani F, Bahri Khomami M, Tohidi M, Azizi F. To what extent does the use of the Rotterdam criteria affect the prevalence of polycystic ovary syndrome? A community-based study from the Southwest of Iran. Eur J Obstet Gynecol Reprod Biol 2014; 174: 100–105.

[39] Lizneva D, Suturina L,Walker W, Brakta S, Gavrilova-Jordan L, Azziz R. Criteria, prevalence, and phenotypes of polycystic ovary syndrome. Fertil Steril 2016; 106: 6–15.

[40] Varanasi LC, Subasinghe A, Jayasinghe YL, Callegari ET, Garland SM, Gorelik A et al. Polycystic ovarian syndrome: Prevalence and impact on the wellbeing of Australian women aged 16–29 years. Aust N Z J Obstet Gynaecol 2018; 58: 222–233.

[41] Legro RS, Arslanian SA, Ehrmann DA, Hoeger KM, Murad MH, Pasquali R et al. Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2013; 98: 4565–4592.

[42] Roe AH, Dokras A. The diagnosis of polycystic ovary syndrome in adolescents. Rev Obstet Gynecol 2011; 4: 45–51.

[43] Bharathi RV, Swetha S, Neerajaa J, Madhavica JV, Janani DM, Rekha SN et al. An epidemiological survey: Effect of predisposing factors for PCOS in Indian urban and rural population. Middle East Fertil Soc J 2017; 22: 313–316.

[44] Tehrani FR, Rashidi H, Azizi F. The prevalence of idiopathic hirsutism and polycystic ovary syndrome in the Tehran lipid and glucose study. Reprod Biol Endocrinol 2011; 9: 144.

[45] Desai NA, Tiwari RY, Patel SS. Prevalence of polycystic ovary syndrome and its associated risk factors among adolescent and young girls in ahmedabad region. Indian Journal of Pharmacy Practice 2018; 11: 119–125.

[46] Christensen SB, Black MH, Smith N, Martinez MM, Jacobsen SJ, Porter AH et al. Prevalence of polycystic ovary syndrome in adolescents. Fertil Steril 2013; 100: 470–477.

[47] Bhuvanashree N, Gupta S, Anitha M, Venkatarao E. Polycystic ovarian syndrome: Prevalence and its correlates among adolescent girls. Ann Trop Med Public Health 2013; 6: 632–636.

[48] Hickey M, Doherty DA, Atkinson H, Sloboda DM, Franks S, Norman RJ et al. Clinical, ultrasound and biochemical features of polycystic ovary syndrome in adolescents: implications for diagnosis. Hum Reprod 2011; 26: 1469–1477.

[49] Salehpour S, Esmaeilnia Shirvani H, Entezari A. Evaluation of the prevalence of polycystic ovarian syndrome among adolescent (15–18 Years Old) girls in Tehran during 2005–2006. Int J Fertil Steril 2010; 4: 122–127.

[50] Hashemipour M, Faghihimani S, Zolfaghary B, Hovsepian S, Ahmadi F, Haghighi S. Prevalence of polycystic ovary syndrome in girls aged 14–18 years in Isfahan, Iran. Horm Res 2004; 62: 278–282.