Increased mortality in polycystic ovary syndrome- a cohort study

Polycystic ovary syndrome (PCOS) is associated with high comorbidity risk, whereas the data on mortality are inconsistent. The objective was to investigate all-cause and cause-specific mortality risks in women with PCOS.

A cohort study utilizing 1:3 matched cases and controls. The follow-up started at the diagnosis of PCOS.

All women with ICD 8-10 codes for PCOS during January, 1, 1969 to December, 31, 2019 were identified from Finnish nationwide health-care records (N = 9839). Women with PCOS were compared to age and residential area-at-birth-matched control women who did not have a PCOS diagnosis (N = 28 238). Crude and adjusted Cox proportional hazards models were fitted, adjusting for education level and diagnosed conditions (obesity, type 2 diabetes, and hypertension; yes vs no). The results were reported as hazard ratios (HRs) with 95% confidence intervals.

During the median follow-up time of 12 years, 2.02% (n = 199/9839) of women with PCOS had died compared to 1.43% (n = 403/28 238) of controls. Women with PCOS had increased overall mortality after adjusting for education level, obesity, type 2 diabetes, and hypertension (adjusted HR = 1.33 [1.12-1.59]). Mortality due to neoplasms (education adjusted HR = 1.39 [1.04-1.86]) and diseases of the circulatory system (education adjusted HR = 1.68 [1.14-2.50]) was increased. Additionally, mortality due to endocrine, nutritional, and metabolic diseases was increased in the unadjusted model (HR = 2.48 [1.03-5.98]), but not in the education-adjusted model.

The results suggest that women with PCOS have an increased overall mortality compared to women without PCOS. Effective strategies to reduce mortality risk in women with PCOS should be investigated.