Key result
Pregnancy is linked to worsening POTS symptoms in ~81% of patients.
Why the study?
The study was conducted to evaluate the relationship between postural orthostatic tachycardia syndrome (POTS) and pregnancy.
Does pregnancy worsen symptoms in female patients with postural orthostatic tachycardia syndrome?
Cross-Sectional (n=8,941)
Yes
Does pregnancy worsen symptoms in female patients with postural orthostatic tachycardia syndrome?
In patients with POTS, symptoms typically worsen during pregnancy, particularly in the first and third trimesters, with first-trimester symptom course serving as a useful predictor for the remainder of the pregnancy.
POTS symptom worsening in pregnancy warrants monitoring; Level 4 cross-sectional data leaves open causal confirmation and management guidance.
OBJECTIVE: To evaluate the relationship between postural orthostatic tachycardia syndrome (POTS) and pregnancy. DESIGN: Cross-sectional survey. SETTING: International. SAMPLE: A total of 8941 female patients with a diagnosis of POTS. METHODS: Data from the survey were analysed using descriptive measures and stratified for comparisons. MAIN OUTCOME MEASURES: Symptom course of POTS during pregnancy. Secondary outcomes included pregnancy loss, POTS onset during pregnancy and the impacts of a comorbid diagnosis of Ehlers-Danlos syndrome or an autoimmune disorder on symptoms during pregnancy. RESULTS: Overall, 40.8% (n = 3652) of participants reported one or more pregnancies. Most participants experienced worsening of symptoms in the first (62.6%) and third (58.9%) trimesters and 3 months after pregnancy (58.7%), and 81.1% experienced worsening symptoms at any point in their pregnancy. Most participants with worsening symptoms in the first trimester also experienced worsening symptoms in the second (61.6%) and third (68.1%) trimesters, but if they improved in the first trimester then this improvement persisted in the second and third trimesters. Of participants who reported that POTS was triggered by a specific event (41.3%), 8.1% reported pregnancy as the trigger for the onset. CONCLUSIONS: Postural orthostatic tachycardia syndrome symptoms in the first trimester of pregnancy may help predict symptom course throughout the duration of pregnancy. Some individuals may experience an initial onset of POTS during pregnancy. This novel information may guide clinicians in counselling patients with POTS who are planning pregnancy.
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Bourne et al. (2023) conducted a cross-sectional in Postural orthostatic tachycardia syndrome (POTS) (n=8,941). Pregnancy was evaluated on Worsening of POTS symptoms at any point during pregnancy. Pregnancy in patients with POTS was associated with a worsening of symptoms at any point during the pregnancy in 81.1% of participants, most commonly in the first and third trimesters.
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