Symptoms of postural orthostatic tachycardia syndrome in pregnancy: a cross-sectional, community-based survey

Abstract

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.