Comparative Analysis of Psychosocial Outcomes and Quality of Life Among Nulligravida, Primigravida, and Multigravida Women Diagnosed With Polycystic Ovary Syndrome (PCOS).

Abstract

Background Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder that significantly impacts women's physical and mental health. While its metabolic and reproductive effects are well-documented, its psychosocial impact-particularly across different reproductive stages-remains underexplored. Gravidity may influence psychological outcomes, with nulligravida women facing fertility-related distress, primigravida women experiencing pregnancy-related anxiety, and multigravida women dealing with cumulative stress and worsening PCOS symptoms. This study aims to compare anxiety, depression, stress, and quality of life (QoL) among these groups to inform targeted, stage-specific interventions that improve psychosocial well-being in women with PCOS. Objective This study aims to compare psychosocial well-being across nulligravida, primigravida, and multigravida women with PCOS. The findings will inform the development of targeted interventions that address the specific psychosocial needs of each reproductive group. Methods This cross-sectional study, conducted from July 2023 to December 2024 at Mardan Medical Complex, involved women aged 18-45 diagnosed with PCOS based on established clinical guidelines. Participants were systematically sampled and categorized by pregnancy history into nulligravida, primigravida, and multigravida groups. Validated instruments were used to assess depression, anxiety, stress, and quality of life. The data were analyzed using Kruskal-Wallis one-way ANOVA and other relevant statistical methods to compare outcomes across the groups. Results In this study of 510 women with PCOS, significant differences were observed across the three gravidity groups. Multigravida women had the highest mean age (32.57±4.76 years) and the highest prevalence of a family history of PCOS (40; 57.14%). Primigravida women exhibited the highest BMI (31.21±3.82) and reported the most favorable quality of life, with 56 (20.51%) rating it as Good. However, this group also had the highest levels of severe anxiety, with 211 (77.29%) reporting it. Severe depression was most prevalent among nulligravida women, with 119 (71.26%) experiencing it, while multigravida women reported the poorest quality of life, with 45 (64.29%) rating it as Poor and 28 (40%) as Very Poor. Multigravida women also had the highest stress levels, with 71 (71.43%) patients reporting high stress, and experienced the most severe PCOS symptoms, including hirsutism in 25 (35.71%) patients and acne in 37 (52.85%) patients. In comparison, severe hirsutism was observed in 49 (29.34%) of nulligravida women and 46 (16.85%) of primigravida women, while severe acne was present in 61 (36.53%) of nulligravida women and 139 (50.92%) of primigravida women. Conclusion These findings highlight the vital importance of personalized, stage-specific care in the effective management of PCOS, ensuring that interventions are responsive to the distinct needs and psychosocial challenges encountered by women at various reproductive stages.