Increased mortality in polycystic ovary syndrome— a cohort study

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