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Saei Ghare Naz, M., Ramezani Tehrani, F., Alavi Majd, H., Ahmadi, F., Ozgoli, G., Rashidi Fakari, F., & Ghasemi, V. (2019). The prevalence of polycystic ovary syndrome in adolescents: A systematic review and meta-analysis. International Journal of Reproductive BioMedicine (IJRM), 17(8), 533–542. https://doi.org/10.18502/ijrm.v17i8.4818
https://doi.org/10.18502/ijrm.v17i8.4818
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- Cited by 23 articles
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Marzieh Saei Ghare Naz
Marzieh Saei Ghare Naz
Student Research Committee, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Fahimeh Ramezani Tehrani
Fahimeh Ramezani Tehrani
Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Hamid Alavi Majd
Hamid Alavi Majd
Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
-
Fazlollah Ahmadi
Fazlollah Ahmadi
Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Giti Ozgoli
Giti Ozgoli
Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Farzaneh Rashidi Fakari
Farzaneh Rashidi Fakari
Student Research Committee, Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Vida Ghasemi
Vida Ghasemi
Student Research Committee, Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Published Date
- Sep 3, 2019
The prevalence of polycystic ovary syndrome in adolescents: A systematic review and meta-analysis
Abstract
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.
References
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[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.
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[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.
[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.